Indicadores clínicos, assistenciais e financeiros do atendimento ao paciente com ferida crônica de um serviço da atenção secundária

Abstract

Introduction: Chronic wounds are a challenge for health services as they take time to heal. In Brazil, data on the prevalence of chronic wounds are still scarce. Similarly, the production of clinical, care or financial indicators resulting from the care of patients with wounds at different levels of health care is not identified. Even with the efforts to improve the generation of health data and improve the dissemination and access to them, the available systems do not provide a complete picture of the population with chronic wounds treated at different levels of care of SUS. Health indicators, in general, are an important tool for decision making in health and can support the improvement of the work process, as well as assist in the structural and human resources reorganization of health units impacting the evaluation and improvement of the quality of care. Objective: To analyze the clinical, care and financial indicators of a specialized service. Método: Estudo transversal, descritivo, realizado em um serviço ambulatorial especializado, em que foram incluídos 30 pacientes. After they accepted to participate in the study, their care data were recorded in the Systematization of Nursing Care in Wounds - managerial (Saefg) system during a 90-day period. Data were analyzed using descriptive statistics. Results: In the three-month period, a total of 283 nursing records were performed. Of 25 possible Saefg indicators, 13 were generated in this study. The median age of the patients was 66 years. As for clinical indicators, 27 (90%) patients had one or more diseases that delay wound healing, the main ones being hypertension, peripheral vascular disease and diabetes. Two patients were affected by wound infection, one of traumatic etiology and one diabetic ulcer. After swab collection and culture and antibiogram examination, the presence of microorganisms such as Klebsiella pneumoniae and Proteus Vulgaris respectively were identified. The total cost with the treatment of the lesions was R$ 11,701.30, of which R$ 1,313.70 with multi-layer compressive therapies, R$ 7,423.20 with Unna boot therapy and R$ 2,966.40 with other materials such as dressings and general use materials. Conclusion: This study provided important indicators about the clinical, care and financial situation of patients with chronic wounds treated in a secondary care unit. Information about the profile of patients, etiology of injuries and expenses with complex therapies constitute a relevant tool for care management in health care units