Readmissões hospitalares no setor de saúde suplementar no Brasil: análise do perfil dos estabelecimentos

• Ano de defesa: 2024
• Autor(a) principal: Priscila Faria de Oliveira
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; ENFERMAGEM - ESCOLA DE ENFERMAGEM; Programa de Pós-Graduação em Gestão de Serviços de Saúde; UFMG
• Palavras-chave em Português: Readmissão do paciente; Continuidade da assistência ao paciente; Hospitais; Readmissão do Paciente; Continuidade da Assistência ao Paciente; Dissertação acadêmica
• Link de acesso: http://hdl.handle.net/1843/72055; https://orcid.org/0000-0001-9291-5758

Hospital readmission within 30 days of discharge is a relevant issue that signals challenges and opportunities to improve the efficiency of the healthcare system and offer safer care to patients. This study investigated the factors associated with preventable hospital readmission rates within 30 days in the context of Brazilian supplementary healthcare, considering the characteristics of patients, hospitals, discharges and the severity of care. Using a quantitative approach, secondary data from the JMJ Audit platform was analyzed from January 2017 to March 2023, aiming to understand the dynamics of readmissions and their systemic implications. The results revealed that the readmission rate within 30 days was 8.79%, and the avoidable readmission rate during this period was 1.59%. Around 18.10% of all readmissions occurred within 30 days. In general, readmissions were more common in female patients (53.39%), medium-sized hospitals (57.14%) and in elective hospitalizations (50.89%). The medical specialties with the highest incidence of avoidable readmissions within 30 days were digestive system surgery (43.66%), otorhinolaryngology (43.54%) and plastic surgery (41.96%), with an average length of stay of less than 2 days. The ICD-10 chapters with the highest proportion of avoidable readmissions were those related to external causes (54.84%), pregnancy, childbirth and the postpartum period (38.69%) and ill-defined causes (33.5%). The mortality rate among patients with avoidable readmission was 4.14%, and the total cost of wasted hospital stays due to avoidable readmissions within 30 days was R$253,934,953 - corresponding to 3.2% of the total spent on hospitalizations and representing an estimated annual value of R$36,276,421.9. Based on the results found, it is understood that the implementation of personalized discharge plans and the promotion of post-discharge home care are promising strategies to reduce avoidable readmissions. This research contributed to the advancement of knowledge about hospital readmissions in the private health system in Brazil. The results indicate possible improvements in the system's efficiency and the provision of safer care to users, contributing to the sustainability of the national health system.