Perfil dos atendimentos em urgência e emergência em um centro de atenção integrada à saúde
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2020-04-04
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Universidade Federal de Goiás
Resumo
Introduction: Urgent and emergency care has undergone important restructuring since
2003, with the creation of the National Policy for Attention to Urgencies, by the Ministry of
Health. Based on this, the urgency and emergency service started to be composed of a
network of units specialized in providing this service at levels of secondary or tertiary care,
depending on its structuring and resolution capacity, with primary care responsible for the
care of low complexity emergencies. Objective: To analyze the profile of the demand of
patients admitted to the emergency room at an Integrated Health Care Center. Methods:
This is a cross-sectional, descriptive study with a quantitative approach. To analyze the
demand profile of patients admitted to the urgency and emergency, linked to the request for
AIH through the Regulation System. All AIHs requested from January 1, 2018 to June 30,
2018 were evaluated. Patients of both genders, any age, and any city of origin were included,
and cases with incomplete AIH were excluded for the survey data. The data referring to the
sociodemographic profile (gender, age group and city of origin), data from the requested AIH
(month of application, period of application and regulation, waiting interval, medical specialty,
and application opinion), initial diagnoses were analyzed related to AIH, and the
characterization of the approved AIH (executing establishment and purpose of the AIH). The
data were analyzed using descriptive statistics, obtaining the absolute and relative frequency
of the variables, in addition to Pearson's Chi-square test to compare the study variables, with
significance of p <0.05. The study was submitted to and approved by the Research Ethics
Committee. Results: A total of 2013 AIHs were selected for the sample. Male gender was
more prevalent with 1021 cases (50.72%). Age ranged from 1 to 101 years, with a mean of
44.24 years (SD ± 23.13). The age group ≥50 years was more frequent, with 43.52% of the
cases, in relation to the other categories (p <0.001). In relation to the municipality of origin,
the highest number of cases was observed for Aparecida de Goiânia with 66.57% of the
records, followed by Goiânia with 18.03%. In general, there was no variation per month. As
for the request and regulation period, the day shift was noted as the most frequent with
68.95% and 69.50% of cases, respectively. The most prevalent waiting intervals were 60 min
(45.11%), 1 to 6 hours (23.00%), 6 to 12 hours (5.81%), and 12 to 24 hours (11.03%).
Regarding the request's opinion, a total of 71.49% was approved, while 17.14% was denied.
About 5.32% of patients were discharged, and 5.12% escaped from the site. The specialties
most frequently requested were general practice (54.25%), general surgery (18.63%) and
pediatrics (12.62%). The most observed health problems were acute abdomen (8.00%),
stroke (7.65%) and other intracranial injuries (6.46). The services required for the most
frequent approved AIHs were highly complex procedures (36.00%), evaluation by a specialist
(35.86%), and hospitalization (25.85%). Public establishments were the most frequent with
76.86, followed by private (19.88%). Conclusions: Problems with structure, equipment for
exams and qualified labor were observed, in addition to the excessive request for highly
complex exams, due to the absence of internal protocols to guide your request. In addition,
like profile there was a higher frequency for males, aged> 50 years and from Aparecida de
Goiânia. Most of the cases were approved in the 60 min waiting interval, mainly related to
acute abdomen. The purpose of AIHs was frequent to the evaluation of urgency and tests of
high complexity in public establishments.
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COSTA, W. M. Perfil dos atendimentos em urgência e emergência em um centro de atenção integrada à saúde. 2020. 109 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2020.