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INTRODUĂĂO: A prevalĂȘncia de feridas nas unidades de saĂșde Portuguesas nĂŁo Ă©
totalmente conhecida; simultaneamente a gestĂŁo de custos do seu tratamento Ă©
insuficiente. Para caraterizar este fenĂłmeno decidimos estudar o portador de feridas, a
epidemiologia e custos associados ao seu tratamento, nos contextos de cuidados de
saĂșde primĂĄrios (CSP) e diferenciados (CSD), organizados por NUTS II. MATERIAL
E MĂTODOS: Estudo epidemiolĂłgico que decorreu no perĂodo de Janeiro de 2012 a
Dezembro de 2013, tendo sido estudados todos os utentes internados nos CSD e os que
recorreram aos CSP. As feridas foram agrupadas de acordo com a etiologia e
cronicidade; bem como, caracterizadas segundo a localização, origem, tempo de
existĂȘncia, dor, pele circundante e infecção. Foram, ainda, estimados os custos diretos
do tratamento, por tipologia e contexto de cuidados. RESULTADOS: Dos 108840
utentes examinados, 5274 apresentavam feridas, correspondendo a uma prevalĂȘncia de
feridas de 4,84% nos utentes observados e uma prevalĂȘncia estimada de 3,3 portadores
de ferida por 1000 habitantes em Portugal. A prevalĂȘncia global de feridas nos CSD foi
de 33%, onde 1 em cada 3 utentes internados apresenta ferida, e nos CSP foi de 2,2
/1000 habitantes. As feridas crĂłnicas representam uma prevalĂȘncia estimada de 1,6
/1000 habitantes: Ălcera PressĂŁo 0,7/1000 habitantes; Ălcera Perna 0,7/1000 habitantes;
Pé Diabético 0,15/1000 habitantes; e Ferida Maligna 0,1/1000 habitantes. Quanto ao
portador de ferida, dos fatores de risco mais associados salientam-se a HTA (40%) e a
diabetes (23%). Foram identificadas: taxa de infeção nos tecidos profundos em 17,6% e
dor na ferida em 65,7%; A dimensão média da ferida foi de 15,39 cm2, superior da
ferida crónica em relação ferida aguda (37,81cm2 Versus 15,39 cm2). O tempo de
existĂȘncia de uma ferida foi em mĂ©dia de 189 dias, sendo significativamente superior na
ferida crónica em relação à ferida aguda (412 dias versus 32 dias) . A duração média por
tratamento foi de 15,72 minutos, com um custo mĂ©dio estimado em 8,12âŹ, sendo que o
valor médio foi significativamente superior em nas feridas crónicas em relação à s
feridas agudas (11,01⏠versus 6,08âŹ). CONCLUSĂO: Os resultados deste estudo
constituem-se num recurso valioso para a gestão estratégica dentro do Sistema Nacional
de SaĂșde em termos de requisitos educacionais, diretrizes clĂnicas, custos e iniciativas
de investigação.
INTRODUCTION: The prevalence of wounds in the Portuguese health facilities is not fully known; while managing costs of treatment is insufficient. To characterize this phenomenon we decided to study the bearer of wounds, epidemiology and costs associated with their treatment in primary health care settings (CSP) and differentiated care settings (CSD), organized by NUTS II. METHODS: Epidemiological study took place from January 2012 to December 2013, have been studied all users admitted in the CSD and those who resorted to CSP. The wounds were grouped according to the aetiology and chronicity; and, characterized by location, origin, time of existence, pain, surrounding skin and infection. It also estimated the direct costs of treatment, type and context of care. RESULTS: Of the 108 840 users surveyed, 5274 had wounds, corresponding to a wound prevalence of 4.84% in the observed users. and an estimated wound prevalence of 3.3 patients per 1,000 inhabitants in Portugal. The overall prevalence of wounds in CSD was 33%, in which 1 in each 3 users has a wound, and CSP was 2.2 / 1000 inhabitants. Chronic wounds represent an estimated prevalence of 1.6 / 1000 inhabitants: Pressure Ulcers 0.7 / 1000 inhabitants; Leg Ulcers 0.7 / 1000 inhabitants; Diabetic Foot 0.15 / 1,000 inhabitants; and Malignant Wounds 0.1 / 1000 inhabitants. As for the user with a wound, the most significant risk factors associated were hypertension (40%) and diabetes (23%). Were identified: infection rate in the deep tissues in 17.6% and wound pain in 65.7%; The average wound size was 15.39 cm 2, higher ratio in chronic wounds than in acute wounds (37.81 versus 15.39 cm2). The time of existence of a wound averaged 189 days, being significantly higher in chronic wounds than acute wounds (412 days versus 32 days). The mean duration of treatment was 15.72 minutes and a average cost estimated of 8.12 âŹ, and the average value was also significantly higher in chronic wounds compared to acute wounds (11.01 ⏠versus 6.08 âŹ). CONCLUSION: The results of this study constitute a valuable resource for strategic management within the National Health System in terms of educational requirements, clinical guidelines, costs and research initiatives.
INTRODUCTION: The prevalence of wounds in the Portuguese health facilities is not fully known; while managing costs of treatment is insufficient. To characterize this phenomenon we decided to study the bearer of wounds, epidemiology and costs associated with their treatment in primary health care settings (CSP) and differentiated care settings (CSD), organized by NUTS II. METHODS: Epidemiological study took place from January 2012 to December 2013, have been studied all users admitted in the CSD and those who resorted to CSP. The wounds were grouped according to the aetiology and chronicity; and, characterized by location, origin, time of existence, pain, surrounding skin and infection. It also estimated the direct costs of treatment, type and context of care. RESULTS: Of the 108 840 users surveyed, 5274 had wounds, corresponding to a wound prevalence of 4.84% in the observed users. and an estimated wound prevalence of 3.3 patients per 1,000 inhabitants in Portugal. The overall prevalence of wounds in CSD was 33%, in which 1 in each 3 users has a wound, and CSP was 2.2 / 1000 inhabitants. Chronic wounds represent an estimated prevalence of 1.6 / 1000 inhabitants: Pressure Ulcers 0.7 / 1000 inhabitants; Leg Ulcers 0.7 / 1000 inhabitants; Diabetic Foot 0.15 / 1,000 inhabitants; and Malignant Wounds 0.1 / 1000 inhabitants. As for the user with a wound, the most significant risk factors associated were hypertension (40%) and diabetes (23%). Were identified: infection rate in the deep tissues in 17.6% and wound pain in 65.7%; The average wound size was 15.39 cm 2, higher ratio in chronic wounds than in acute wounds (37.81 versus 15.39 cm2). The time of existence of a wound averaged 189 days, being significantly higher in chronic wounds than acute wounds (412 days versus 32 days). The mean duration of treatment was 15.72 minutes and a average cost estimated of 8.12 âŹ, and the average value was also significantly higher in chronic wounds compared to acute wounds (11.01 ⏠versus 6.08 âŹ). CONCLUSION: The results of this study constitute a valuable resource for strategic management within the National Health System in terms of educational requirements, clinical guidelines, costs and research initiatives.
Description
Keywords
PrevalĂȘncia de feridas Fatores de risco Custos de tratamento Wounds prevalence Risk factors Costs of treatment