Disparidades entre os serviços público e privado no uso de terapias de reperfusão para pacientes com IAMCSST : registro VICTIM

Detalhes bibliográficos
Ano de defesa: 2016
Autor(a) principal: Oliveira, Laís Costa Souza lattes
Orientador(a): Barreto-Filho, José Augusto
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal de Sergipe
Programa de Pós-Graduação: Pós-Graduação em Ciências da Saúde
Departamento: Não Informado pela instituição
País: Brasil
Palavras-chave em Português:
Área do conhecimento CNPq:
Link de acesso: https://ri.ufs.br/handle/riufs/3777
Resumo: Introduction: The use of reperfusion therapy in the treatment of patients with STEMI, in the shortest time possible, is essential to reduce morbidity and mortality. Previous studies suggest the existence of disparities in the care of patients attended by public and private health services. However, major gaps still exist when this service is focused on patients with STEMI, especially in Brazil. Objective: To estimate disparities in the use of reperfusion therapy for patients diagnosed with STEMI treated in hospitals capable of performing primary angioplasty of public and private in Sergipe. Methods: This is a cross-sectional study with a quantitative approach which used records Study VICTIM. Data were collected in only four hospitals capable of performing primary angioplasty in Sergipe, being one public and three private. We evaluated 301 patients diagnosed with STEMI, 249 of which were treated at public hospitals and 52 in private hospitals from December 2014 until October 2015. Results: On the way to the hospital capable of performing primary angioplasty, 3.2 % of patients treated in public hospitals made use of fibrinolytic, and 1.9% of patients treated in private institutions (p = 1.0). Amongst those patients treated in hospitals with ability to perform primary angioplasty, only 45.3% of treated at the public hospital arrived in ideal time (≤ 12 hours starting from the onset of symptoms), compared with 80.5% of patients treated in private hospitals (p <0.001). The rate of patients who received primary angioplasty in the civil service was significantly lower than the rate observed in private hospitals (39.5% vs 69% respectively, p <0.001). Conclusion: It has been found out that patients with STEMI are not reperfused, both in public and in private services. Moreover, there are significant obstacles related to the logistics of access, in optimum time, to hospitals capable of performing primary angioplasty. This fact is more evident for users of the public network system. Finally, despite the great difficulty of access to such institutions in optimum time, it was observed that a minority of patients in both public and private system, made use of fibrinolytic agents during their commute to the hospital with the ability to perform angioplasty.