Avaliação epidemiológica e econômica do tratamento de pacientes com úlceras por pressão em uma unidade da Fundação Hospitalar do Estado de Minas Gerais FHEMIG

Abstract

Pressure Ulcer (PU) is a lesion in the skin and / or underlying tissues, usually over a bony prominence, as a result of pressure or a combination of these and shear. The prevalence of PU is high, particularly in hospitalized patients. They are associated with increased length of stay and the workload for nursing, increased morbidity and mortality for hospitalized patients and increased costs for health systems. The economic issue is critical for decision-making in the use of therapeutic strategies. In this sense, it was observed that, conducting epidemiological study and Pharmacoeconomics is relevant to support the qualification of health care, providing greater patient safety and optimizing the financial management of the resources available for the treatment of these lesions. The objective was to conduct an economic and epidemiological assessment of the treatment of UPP, under the perspective of Health Unic System, in a hospital to care for chronic patients, in the period from January 2010 to December 2014. The study was divided into two stages: a cohort study and economic evaluation of the cost of the disease. The historical cohort was constructed from data from medical records of hospitalized patients. To evaluate the existence and degree of association between the number of UPP in the admission and the sociodemographic and clinical variables and Braden Scale score a multivariate analysis with Poisson regression was performed. The significance level for analysis was 0.20, with the exception of the final model for which was adopted the 0.05 significance level. To assess the cost of the disease was adopted the methodology based on the System Activity Based Costing (ABC). We evaluated a total of 258 records, most of the patients were male (76.7%) and mulatto (50.4%). The mean age was 47 ± 16.29 years. Of the total, 33.3% progressed to death. The variables that showed statistically significant association with the number of UPP at admission were: mixed skin, age, Braden score at admission, length of stay and death. The incidence and prevalence of PU was 29.41% and 90.70%, respectively. The results of this study show that the incidence of UPP in hospitals rear institutions that serve multiple trauma is very high given the peculiarities of this patient profile. For this reason, the development of a pressure ulcer prevention program suited to a specific population (with multiple trauma injury), as well as relevant, can be regarded as a necessary step towards assistance for these patients. The economic and epidemiological evaluation performed did meet some factors that burden the treatment of PU and economic strategies that can be easily applied in practice.