SUS Homecare in Brazil, the impact of the “Best at Home” program
DOI:
https://doi.org/10.33448/rsd-v11i6.29177Keywords:
Hospital home care services; Home assistance services; Health coast; Aging.Abstract
Introduction: The Brazilian population undergoes intense aging and a consequent increase in multimorbidity, impacting health services. In 2011, the Ministry of Health created the “Best at Home” program with the aim of promoting home care as a possibility to expand hospital beds at the client's home and thus humanize care and reduce costs. Objectives: To analyze home hospitalizations of the Unified Health System (SUS) in the period 2008-2019 and correlate with hospitalization cost, clinical and epidemiological variables. Method: Quantitative study based on data from the Hospitalization System of the Unified Health System (SIH/SUS) from 2008 to 2019, available on the electronic platform of the Department of Informatics of the SUS (DATASUS). For trend analysis, the Mann-Kendall test was used and for analysis of the intervention effect, ARIMA models were adjusted, considering data from 2008-2011 without intervention and from 2012-2019 with intervention. Results: There was an increasing trend in the number of home admissions from 2008 to 2019 (=0.152 and p=0.537), as well as in the average cost per hospitalization (=0.061 and p=0.837) and for females over males (=0.606 and p=0.007). There was a downward trend in the average number of days per hospital stay (= -0.576 and p=0.011) and in the mortality rate (=0.212 and p=0.373). Conclusion: with a cost of less than 10% of the daily value of a hospital stay, home care reduces mortality and average days of hospitalization. Therefore, with population aging, home care programs such as “Best at Home” become fundamental.
References
Alves, M., Vieira, M. B., Costa, J., & Carneiro, A. V. (2017). Analysis of the Cochrane Review: Early Discharge Hospital at Home. Cochrane Database Syst Rev. 2017; 6: CD000356. Acta Medica Portuguesa, 30(12), 835-839.
Antunes, J. L. F., & Cardoso, M. R. A. (2015). Uso da análise de séries temporais em estudos epidemiológicos. Epidemiologia E Servicos De Saude, 24, 565-576.
Association, A. P. (2014). DSM-5: Manual diagnóstico e estatístico de transtornos mentais. Artmed Editora.
Braga, P. P., Sena, R. R. d., Seixas, C. T., Castro, E. A. B. d., Andrade, A. M., & Silva, Y. C. (2016). Oferta e demanda na atenção domiciliar em saúde. Ciencia & Saude Coletiva, 21, 903-912.
Cerezer, L. G., Lampert, M. A., Barberena, L. d. S., Brondani, C. M., & Rizzatti, S. d. J. S. (2017). Avaliação da (Evaluación de la) capacidade funcional de pacientes em atenção domiciliar. Salud (i) ciencia (Impresa), 525-531.
de Oliveira, C. M. V., Maciel, M. E. B., Lima, C. G., Gallindo, G. D., de Souza Simões, J. P., da Silva Carvalho, V. P., & dos Santos, S. C. (2021). Entraves na assistência domiciliar ao idoso: análise da produção científica. Brazilian Journal of Health Review, 4(1), 411-429.
Emiliano, W., Telhada, J., & do Sameiro Carvalho, M. (2017). Home health care logistics planning: a review and framework. Procedia Manufacturing, 13, 948-955.
Fernandes, T. d. P. (2021). Gestão de custos: Aplicação em uma clinica de hemodiálise.
Gonçalves‐Bradley, D. C., Iliffe, S., Doll, H. A., Broad, J., Gladman, J., Langhorne, P., Richards, S. H., & Shepperd, S. (2017). Early discharge hospital at home. Cochrane Database of Systematic Reviews(6).
José Finkelstein, B., & Borges Junior, L. H. (2020). A capacidade de leitos hospitalares no Brasil, as internações no SUS, a migração demográfica e os custos dos procedimentos. JBES: Brazilian Journal of Health Economics/Jornal Brasileiro de Economia da Saúde, 12(3).
Lara, M. (2021a). Há 10 anos, programa “Melhor em Casa” cuida da saúde e dá qualidade de vida a brasileiros com doenças crônicas. https://www.gov.br/saude/pt-br/assuntos/noticias/2021-1/novembro/ha-10-anos-programa-201cmelhor-em-casa201d-cuida-da-saude-e-da-qualidade-de-vida-a-brasileiros-com-doencas-cronicas
Lara, M. (2021b). Melhor em Casa: Ministério da Saúde habilita 116 novas equipes para atendimento domiciliar. Ministério da Saúde. https://www.gov.br/saude/pt-br/assuntos/noticias/2021-1/novembro/melhor-em-casa-ministerio-da-saude-habilita-116-novas-equipes-para-atendimento-domiciliar
Machiwal, D., & Jha, M. K. (2012). Hydrologic time series analysis: theory and practice. Springer Science & Business Media.
Nishimura, F., Carrara, A. F., & Freitas, C. E. d. (2019). Efeito do programa Melhor em Casa sobre os gastos hospitalares. Revista de saude publica, 53, 104.
Oliveira, S. G., & Kruse, M. H. L. (2016). Genesis of home care in Brazil at the start of the twentieth century. Revista gaucha de enfermagem, 37.
Organization, W. H. (2021). International Classification of Diseases. www.who.int www.who.int
Palesy, D., Jakimowicz, S., Saunders, C., & Lewis, J. (2018). Home care in Australia: an integrative review. Home health care services quarterly, 37(2), 113-139.
Rajão, F. L., & Martins, M. (2020). Home Care in Brazil: an exploratory study on the construction process and service use in the Brazilian Health System. Ciencia & Saude Coletiva, 25, 1863-1877.
Severino, A. J. (2017). Metodologia do trabalho científico. Cortez editora.
Siclovan, D. M. (2018). The effectiveness of home health care for reducing readmissions: an integrative review. Home health care services quarterly, 37(3), 187-210.
Silva, K. L., Sena, R. R. d., & Castro, W. S. (2018). A desospitalização em um hospital público geral de Minas Gerais: desafios e possibilidades. Revista gaucha de enfermagem, 38.
Spiecker, E. M., Mincoff Barbanti, P. C., Egger, P. A., de Barros Carvalho, M. D., Pelloso, S. M., Rovery de Souza, M., de Andrade, L., Staton, C. A., Alves, M. L., Menezes de Souza, E., Pedroso, R. B., & Nickenig Vissoci, J. R. (2021). Influence of the global crisis of 2008 and the brazilian political oscillations of 2014 on suicide rates: An analysis of the period from 2002 to 2017. SSM Popul Health, 13, 100754. https://doi.org/10.1016/j.ssmph.2021.100754
Wachs, L. S., Nunes, B. P., Soares, M. U., Facchini, L. A., & Thumé, E. (2016). Prevalência da assistência domiciliar prestada à população idosa brasileira e fatores associados. Cadernos De Saude Publica, 32, e00048515.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Jhony Marcelo Bogado Gabardo; Matheus Jacometo Coelho de Castilho; Ademilson José Bernardineli; Hana Paula Schuroff; Constanza Pujals; Maria Dalva de Barros Carvalho; Sandra Marisa Pelloso; Raíssa Bocchi Pedroso
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
