Gasto de internação de idosos em unidades de terapia intensiva nos hospitais privados de uma capital do nordeste brasileiro / Expenditure on hospitalization of the elderly in intensive care units in private hospitals in a capital of the Brazilian northeast

RESUMO

Resumo Objetivo: Analisar a associação entre variáveis demográficas, de morbidade e relativas às condições da hospitalização com os gastos decorrentes da internação de idosos em unidades de terapia intensiva (UTI) de hospitais privados em uma capital do nordeste brasileiro. Método: Trata-se de um estudo epidemiológico, analítico e do tipo seccional, com abordagem quantitativa, no qual foram coletados dados referentes a 312 internações de idosos em UTI de todos os hospitais privados de Natal (RN), Brasil. A variável dependente foi o custo de internação e as variáveis independentes relacionadas à caracterização dos indivíduos quanto ao perfil sociodemográfico, ao quadro mórbido e às características da internação. Os dados foram analisados por meio de estatística descritiva, teste qui-quadrado, teste t e regressão logística múltipla com as razões de prevalência (RP). Resultados: O custo médio por internação foi de R$ 4.266,05±3.322,50 para o grupo de baixo custo e R$ 39.753,162 ± 4.929,12 para o grupo alto custo. Constatou-se que a hospitalização decorrente de agravos clínicos (RP=1,81; IC95%=1,06-3,09) e respiratórios (RP=2,48; IC95%=1,48-5,24), a necessidade de ventilação mecânica (RP=2,33; IC95%=1,43-3,78) e a desorientação completa ou parcial no momento da admissão (RP=1,81; IC95%=1,15-2,84) estiveram associadas ao maior gasto nas internações no modelo estatístico múltiplo. Conclusão: Esses achados trazem evidências de que a implantação de ações capazes de promover melhores condições de saúde para os idosos, por meio da criação de protocolos e linhas de cuidado, especificamente criados para esse público, podem ser relevantes na redução dos gastos decorrentes da internação de idosos em terapia intensiva. Analyze the association between demographic variables, morbidity and relative to the conditions of hospitalization with the expenses resulting from the admission of elderly people in intensive care units (ICU) of private hospitals in a capital of northeastern Brazil. Method: This is an epidemiological, analytical and sectional study, with a quantitative approach, in which data were collected regarding 312 hospitalizations of elderly people in the ICU of all private hospitals in Natal (RN), Brazil. The dependent variable was the cost of hospitalization and the independent variables related to the characterization of individuals in terms of socio-demographic profile, morbid condition and characteristics of hospitalization. Data were analyzed using descriptive statistics, Chi-square test, t test and multiple logistic regression with prevalence ratios (PR). Results: The average cost per hospitalization was R$ 4.266,05±3.322,50 for the low cost group and R$ 39.753,162±4.929,12 for the high cost group. It was found that hospitalization due to clinical (PR=1,81; 95%CI=1,06-3,09) and respiratory conditions (PR=2,48; 95CI%=1,48-5,24), the need for mechanical ventilation (PR=2,33; 95%CI=1,43-3,78) and complete or partial disorientation at the time of admission (PR=1,81; 95%CI=1,15-2,84) were associated with higher expenditure on hospitalizations in the multiple statistical model. Conclusion: The knowledge produced by the study may serve as a subsidy for the implementation of actions capable of promoting better health conditions for the elderly, reducing expenses related to their hospitalization in highly specialized sectors. In addition, the research raises evidence that the construction of protocols and lines of care guiding the work process in the intensive care sector, specifically created for the elderly, may be relevant in reducing the expenses resulting from hospitalization of the elderly.

ABSTRACT

Abstract Objective: Analyze the association between demographic variables, morbidity and relative to the conditions of hospitalization with the expenses resulting from the admission of elderly people in intensive care units (ICU) of private hospitals in a capital of northeastern Brazil. Method: This is an epidemiological, analytical and sectional study, with a quantitative approach, in which data were collected regarding 312 hospitalizations of elderly people in the ICU of all private hospitals in Natal (RN), Brazil. The dependent variable was the cost of hospitalization and the independent variables related to the characterization of individuals in terms of socio-demographic profile, morbid condition and characteristics of hospitalization. Data were analyzed using descriptive statistics, Chi-square test, t test and multiple logistic regression with prevalence ratios (PR). Results: The average cost per hospitalization was R$ 4.266,05±3.322,50 for the low cost group and R$ 39.753,162±4.929,12 for the high cost group. It was found that hospitalization due to clinical (PR=1,81; 95%CI=1,06-3,09) and respiratory conditions (PR=2,48; 95CI%=1,48-5,24), the need for mechanical ventilation (PR=2,33; 95%CI=1,43-3,78) and complete or partial disorientation at the time of admission (PR=1,81; 95%CI=1,15-2,84) were associated with higher expenditure on hospitalizations in the multiple statistical model. Conclusion: The knowledge produced by the study may serve as a subsidy for the implementation of actions capable of promoting better health conditions for the elderly, reducing expenses related to their hospitalization in highly specialized sectors. In addition, the research raises evidence that the construction of protocols and lines of care guiding the work process in the intensive care sector, specifically created for the elderly, may be relevant in reducing the expenses resulting from hospitalization of the elderly.