| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 71.97 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Problemática - Os custos com os cuidados de saúde em geral, incluindo os custos com os
cuidados continuados, fruto de uma maior esperança de vida ao nascer e do aumento na
incidência de doenças crónicas tenderão a aumentar, prevendo-se que no ano de 2050 o
rácio sobre o PIB duplique em relação ao existente em 2010, tornando-se assim fundamental
conhecer a estrutura de custos das diferentes tipologias de cuidados.
Objetivos - Identificar os custos de funcionamento das ECCI associados ao tempo despendido
pelos profissionais, aos materiais de consumo clinico e farmacêutico, às deslocações
por cliente; Identificar os custos indiretos das ECCI por cliente; Identificar as necessidades
em cuidados, as intervenções implementadas e os ganhos em saúde sensíveis aos cuidados
de enfermagem dos clientes das ECCI e identificar relações entre: necessidades, intervenções,
ganhos em saúde e custos de funcionamento das ECCI.
Material e métodos - Estudo transversal cuja recolha de dados decorreu entre de 1 de
setembro e 31 de dezembro de 2012; trata-se de um estudo exploratório e correlacional.
A amostra foi temporal e corresponde aos clientes internados nas ECCI da ULSM no período
em estudo. Para a recolha de dados recorremos à análise documental dos planos e relatórios
de atividades e contas; à informação disponível nas bases de dados dos sistemas de
informação em uso. E à proveniente das respostas ao formulário eletrónico construído.
Resultados - Na estrutura de custos a prestação direta de cuidados é a que consome mais recursos
(47%); seguida da utilização dos sistemas de informação (28,4%), ficando as outras atividades
abaixo de 11%. A intervenção mais realizada e que consome mais MCCF é o tratamento
de feridas. O custo médio por dia por cliente foi de 17,79€, o custo por contacto 15,90€ e os
custos indiretos, representam (16,72%) na totalidade dos custos.
Conclusões – Os custos de funcionamento das ECCI são substancialmente inferiores aos verificados
nas unidades de internamento da RNCCI. Os que têm maior impacto situam-se nos grupos
de clientes que são mais dependentes e em cuidados paliativos, têm feridas mais complexas,
mas também nos que apresentam mais ganhos globalmente A prevenção de complicações
sobretudo em doentes com dependência é fundamental para uma melhor eficiência dos serviços
de saúde e para um melhor controlo da despesa. Se queremos um Serviço Nacional de
Saúde mais sustentável financeiramente deveremos tomar medidas para organizarmos cada
vez mais respostas de cuidados de proximidade, mantendo as pessoas em casa com suporte
profissionalizado para os cuidados de saúde como para os que são hoje assumidos pelos membros
da família prestador de cuidados.
Problematic - The costs of health care in general, including the costs of continuous care, the result of higher life expectancy at birth and the increase in the incidence of chronic diseases tend to enlarge, so it is expected that in the year 2050 the ratio of GDP (Gross National Product) will double from the existing in 2010, thereby it is essential to understand the cost structure of the different types of health care. Goals – To identify the operating costs of the Team of Integrated Continuous Care related to the time spent by professionals, to the clinical consumables and pharmaceuticals, to travel by customer; to identify the indirect costs of the TICC by each customer; to identify the needs in care, the implemented interventions and health outcomes sensitive to nursing care of clients of TICC and identify relationships between: needs, interventions, health gains and operating costs of the TICC. Material and methods – It is a sectional study whose data collection took place between September 1st and December 31st, 2012; it is an exploratory and correlational study. The sample was temporal and corresponds to clients hospitalized in the ECCI in Matosinhos Local Healthcare Unit (ULSM) in the period of this study. For data collection we used the documentary analysis of plans and activity reports and accounts; we also used the information available in databases of information systems in use, and to the responses from the electronic form built. Results - In the cost structure, the direct care is the one which consumes more resources (47%); then, the use of information systems (28.4%), and the other activities are below 11%. The intervention carried out more and consuming more clinical supplies and pharmaceutical material (MCCF) is the treatment of wounds. The average cost per day per customer was 17.79 euros, the cost per contact 15.90 euros and the indirect costs which represent (16.72%) at all costs. Conclusions - The running costs of the TICC are substantially lower than those observed in the inpatient units of NNICC (The National Network of Integrated Continuous Care). The greatest impact, are located in the client groups who are more dependent and in palliative care, those who have more complex wounds, but also in those with more gains globally. The prevention of complications mainly in patients with dependence is fundamental for a better efficiency health services and a better expenses control. If we want a National Health Service more sustainable financially we should take steps to organize more and more community- based care responses, keeping people at home with professionalized support for health care and for those who are nowadays made by members of the family provider care.
Problematic - The costs of health care in general, including the costs of continuous care, the result of higher life expectancy at birth and the increase in the incidence of chronic diseases tend to enlarge, so it is expected that in the year 2050 the ratio of GDP (Gross National Product) will double from the existing in 2010, thereby it is essential to understand the cost structure of the different types of health care. Goals – To identify the operating costs of the Team of Integrated Continuous Care related to the time spent by professionals, to the clinical consumables and pharmaceuticals, to travel by customer; to identify the indirect costs of the TICC by each customer; to identify the needs in care, the implemented interventions and health outcomes sensitive to nursing care of clients of TICC and identify relationships between: needs, interventions, health gains and operating costs of the TICC. Material and methods – It is a sectional study whose data collection took place between September 1st and December 31st, 2012; it is an exploratory and correlational study. The sample was temporal and corresponds to clients hospitalized in the ECCI in Matosinhos Local Healthcare Unit (ULSM) in the period of this study. For data collection we used the documentary analysis of plans and activity reports and accounts; we also used the information available in databases of information systems in use, and to the responses from the electronic form built. Results - In the cost structure, the direct care is the one which consumes more resources (47%); then, the use of information systems (28.4%), and the other activities are below 11%. The intervention carried out more and consuming more clinical supplies and pharmaceutical material (MCCF) is the treatment of wounds. The average cost per day per customer was 17.79 euros, the cost per contact 15.90 euros and the indirect costs which represent (16.72%) at all costs. Conclusions - The running costs of the TICC are substantially lower than those observed in the inpatient units of NNICC (The National Network of Integrated Continuous Care). The greatest impact, are located in the client groups who are more dependent and in palliative care, those who have more complex wounds, but also in those with more gains globally. The prevention of complications mainly in patients with dependence is fundamental for a better efficiency health services and a better expenses control. If we want a National Health Service more sustainable financially we should take steps to organize more and more community- based care responses, keeping people at home with professionalized support for health care and for those who are nowadays made by members of the family provider care.