Internações hospitalares de pacientes submetidos ao tratamento oncológico pelo sistema único de saúde

Abstract

INTRODUCTION: Hospitalizations are part of the trajectory of cancer patients and the fragmentation of the Brazilian health model, late diagnosis and inequalities in access to treatment make the scenario troubling public health system in Brazil. OBJECTIVES: This study aimedknow to investigated the factors associated with hospitalization and length of hospital stay in patients with neoplasms, in the first year after initial treatment in the Sistema Único de Saúde (SUS), between 2010 and 2014, for the most incidence types of cancer in brazilian population. METHOD: Observational research, non_concurrent cohort. The data were obtained from the Dates National Oncology Database. Constructed by deterministic-probabilistic linkage of ambulatorial, hospitalar and mortality health system information, provided by DataSUS. The logistic regression model was the technique used to investigate the association of explanatory variables with the risk of hospitalization. Through the negative binomial regression model, we analyze the time (in days) of hospital stay.It estimated the relative risk (RR) and 95% confidence interval (95% CI) and p value for each variable. RESULTS: The study population, 417 477 patients, mostlywomen between 60 and 79 years (48.2%) and residents of the Southeast region (47.5%). Men with prostate cancer and women with breast cancer amounted to 63.0%. More than half (53.3%) began chemotherapy (56.6%) with tumor stage III and IV. Most had other comorbidities.142 061 people (34%) admitted, especially the oncology clinical complications. The greatest risk of hospitalization * and stay longer hospitalized **, respectively, was for men(* RR = 0.84, CI: 0,82- 0,86) and (** RR = 0.98 for women; CI: 0.97-0.99); stomach tumors (* RR = 4.42, CI: 4.27 to 4.48), colon and rectum (** RR = 1.37, CI: 1,35- 1,40); and comorbidities (* RR = 1.19, CI: 1.18 to 1.19) and (** RR = 1.03, CI: 1,02- 1,03). Each year of life fell 2% risk of hospitalization and 1% the risk of long hospital stay. north of patients had a lower risk of hospitalization and longer hospital stay. CONCLUSION: The results of this study pointed to the importance of rethinking the effectiveness of oncological patient care, the equity of access in hospital care, the investment of resources in palliative care programs and how to alleviate Brazilian regional inequalities in health.