Atenção domiciliar: análise do perfil dos pacientes na utilização de recursos e custos em uma cidade do sudeste do Brasil

Abstract

Home Care (HC) is a care modality that returns to the world environment aiming to optimize health care burden as well as to provide safety and effective supporting to the patients. Objective: To analyze Home Care Service in relation to the patients´ profile on the use of resources and costs from the public health care in a city in southeastern Brazil. Method: This is a cross-sectional, exploratory, descriptive – analytic, retrospective (2014) study with a quantitative approach of a Home Care Service (HCS). Data collection was performed through the analysis of patients' records, data from the warehouse and the information system of the HCS and the Unified Health System (SUS). The research project was approved by the Ethics Committee (n . 1,268,061). Results: Out of the 621 patients undergoing the HC service; women were predominant 55.1% ; elderlies 74.9%; with elementary education, 63%. Cerebral Vascular Accident-29.5% was the main reason for these elderlies´ admission. Yearly indicators showed a mean of 230.42 (SD: 74.52) patients, mean length of staying 145.80 (SD: 23.66) days, mean number of medical care 2,969.04 (SD: 960.69) and mean rate of SAD procedure was 840.7 (SD: 5.99), mean of hospital discharge 6.31% (SD 5.999) , mean of death rate-4.87% (SD: 4.74) and de-hospitalization 2.50% (2.40). Total cost amount of HCS was a mean of R$ 215,595.00, and the total cost of the patients´ hospitalization at HC R$ 1, 648.00. The difference between the average patient cost / day of HCS and the average patient / day cost of the hospitalization of these patients ranged from R $ 28.26 to R $ 294.46, with the average patient / day cost of HCS 1.041% lower than the cost of hospital admission. Conclusion: These findings allowed to outline the care activities according to the patients´ profile, and the indicators have guided the decision-making of the nurse manager to improve the management of the service. The difference found in this study has provided subsidies for the case management of each patient according to their needs at home and strengthens the economic viability and assistance at HC, as well as the effective use of the resources in the public health system.