O aumento da demanda pelo Pronto Atendimento é um fenômeno mundial, e seu uso inapropriado é um dos principais problemas. Há necessidade de identificar os fatores relacionados para orientar melhoria da qualidade dos serviços. Objetivo: analisar os fatores associados ao uso inapropriado em serviços de Pronto Atendimento. Métodos: estudo transversal com dados de 384 prontuários de pacientes atendidos em dois serviços de Pronto Atendimento de um município do centro-sul do Paraná/Brasil em 2013. A análise foi descritiva, bivariada pelo Qui-quadrado de Pearson para verificar associações entre uso inapropriado e variáveis independentes. Realizou-se Regressão Logística Múltipla. Resultados: A proporção do uso inapropriado de Pronto Atendimento foi de 73,4% e apresentou associação com pessoas com alguma condição sensível a atenção primária (OR=2,55, residentes em áreas sem cobertura de atenção primária (OR=2,30), pessoas entre 0 e 11 anos (OR=4,37), e 12 a 17 anos (OR=3,67), atendimento no primeiro trimestre do ano (OR=0,40), doenças do aparelho respiratório (OR=3,79), lesões e envenenamentos (OR=0,11) e doenças do sistema osteomuscular (OR=3,20). Conclusões: Necessita-se fortalecer a atenção primária para redução do uso inapropriado do Pronto Atendimento, especialmente na atenção às condições sensíveis à atenção primária e ampliação da acessibilidade sócio-organizacional.
Palavras-chave:
Serviços Médicos de Emergência; Atenção Primária à Saúde; Avaliação em Saúde
Abstract:
The increase in the demand for Emergency Services is a worldwide phenomenon, and its inappropriate use is one of the main problems. There is necessity to identify the factors related to guide improvement in the quality of services. Objective: to analyze factors associated with the inappropriate use of emergency services. Methods: A cross-sectional study with secondary data384 medical recordstwo emergency services in a city in central-southern region of Paraná State/Brazil in 2013. The analysis was descriptive, bivariate by Pearson\'s X2 to verify associations between inappropriate use and independent variables. Multiple Logistic Regression was performed. Results: The proportion of inappropriate use of Emergency Care was 73.4% and was associated with people with some primary health care sensitive conditions (OR = 2.55), residents in areas without primary care coverage (OR = 2.30), people between 0 and 11 years old (OR = 4.37), and 12 to 17 years old (OR = 3.67), care in the first trimester of the year (OR = 0.40), respiratory diseases OR = 3.79), lesions and poisonings (OR = 0.11) and diseases of the musculoskeletal system (OR = 3.20). Conclusions: It is necessary to strengthen primary care to reduce the inappropriate use of care, especially in the attention to primary health care sensitive conditions and to increase the socio-organizational accessibility.
Keywords:
Emergency Medical Services; Primary Health Care; Health Evaluation.
Factors associated to inappropriate use of emergency services.
Resumo (abstract):
The increase in the demand for Emergency Services is a worldwide phenomenon, and its inappropriate use is one of the main problems. There is necessity to identify the factors related to guide improvement in the quality of services. Objective: to analyze factors associated with the inappropriate use of emergency services. Methods: A cross-sectional study with secondary data384 medical recordstwo emergency services in a city in central-southern region of Paraná State/Brazil in 2013. The analysis was descriptive, bivariate by Pearson\'s X2 to verify associations between inappropriate use and independent variables. Multiple Logistic Regression was performed. Results: The proportion of inappropriate use of Emergency Care was 73.4% and was associated with people with some primary health care sensitive conditions (OR = 2.55), residents in areas without primary care coverage (OR = 2.30), people between 0 and 11 years old (OR = 4.37), and 12 to 17 years old (OR = 3.67), care in the first trimester of the year (OR = 0.40), respiratory diseases OR = 3.79), lesions and poisonings (OR = 0.11) and diseases of the musculoskeletal system (OR = 3.20). Conclusions: It is necessary to strengthen primary care to reduce the inappropriate use of care, especially in the attention to primary health care sensitive conditions and to increase the socio-organizational accessibility.
Palavras-chave (keywords):
Emergency Medical Services; Primary Health Care; Health Evaluation.
Baratieri, T, Lentsck, M.H, Corona, L.P., Almeida, K.P, Kluthcovsky, A.C.G.C, Natal, S. Fatores associados ao uso inapropriado do pronto atendimento.. Cien Saude Colet [periódico na internet] (2019/ago). [Citado em 22/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/fatores-associados-ao-uso-inapropriado-do-pronto-atendimento/17324?id=17324
