Auditoria na análise de causas e custos da hospitalização prolongada, em unidade de internação clínica, de um hospital universitário no Paraná

Abstract

A major political crisis has settled in Brazil, which ends up being responsible for financial problems in the most diverse areas; and the area of health, which by nature is already a more susceptible area, needs even more attention, analysis and strategic management because of this situation. According to data from the Ministry of Health, the largest financial demand in the sector is related to hospital care; and hospitalization time is directly linked to maintaining stability in these costs; as well as raising them further. In view of the above, the objective of the present study was to identify the main causes of prolonged hospitalization in a clinical hospital unit of a University Hospital, through a hospital audit. It is a study of applied nature, quantitative and qualitative approach, with descriptive and explanatory purpose; application of field, retrospective, using technical procedures of documentary analysis. The sample of the research is non-probabilistic, for convenience, composed of all patient / patient records with prolonged hospitalization, equal to or greater than 10 days of hospitalization, and were attended in the period from July 2015 to June 2018, hospitalized at the Clinical Medical Unit of a University Hospital in Paraná. The data referring to the analysis of diagnoses, length of stay, age and delay in the expert evaluations were processed in Excel 2013, using the graphics too. The GraphPad® 7.04 software was used for the statistical tests in the results referring to the number of hospitalizations per period, administrative / bureaucratic failures, nonconformities related to the multiprofessional team and costs, adopting a significance level of 5% (α = 0.05 ). During the study period, there were 1,384 hospitalizations at the hospital's Clinical Medical Unit, of which 317 (22.9%) exceeded 10 days of stay, as well as the timeframes of procedures standardized by SUS; thus composing the research sample. The analysis through the audit generated the conclusion that the profile of patients / patients with prolonged hospitalization refers to the elderly with respiratory problems. Being that the detected nonconformities are directly related to failures in interprofessional and intersectorial communication. And the increase in days of internment that these nonconformities generated, entailed a higher cost than the compensation values of the SUS Tables; which do not even cover the costs of basic hospitalization. Being the interdisciplinary action in health is an excellent alternative to transform this reality.Aguiar