Desdobramentos da multimorbidade a partir da internação hospitalar

Abstract

The management of information associated with the occurrence of multimorbidity in hospital care is relevant to the planning of strategies to prevent health problems in high-risk patients, in order to enable the organization of health systems in an efficient manner. The overall study objective is evaluate multimorbidity based on hospitalization. A quantitative study was carried out a descriptive cross-sectional study with 445 patients admitted to a university hospital in 2018. Data were collected through telephone interview. Multimorbity was considered as variable dependent and independent: use of health services, sociodemographic and Lifestyle. Results were analyzed descriptively and by logistic regression analysis. For delineating the formal path followed by patients according to multimorbidity has developed a flowchart, representing the points of the public health network used by these patients in the postdischarge hospital The results showed that 31.4% present multimorbidity. Larger odds of multimorbidity in individuals between 41 and 60 years old (OR = 4.25), in those over 60 (OR = 14.89), in patients who were hospitalized in the medical clinic, neurology, (OR = 7.76), sedentary (OR = 1.71), obese (OR = 3.01) and in need help for perform daily activities after hospital discharge (OR = 1.75). It was also verified, through the follow-up of the path taken by these patients, a high prevalence of referral (with multimorbidity (CM) 93.5%; without multimorbidity (SM) 97.7%) and attendance at attention secondary to health (CM 86.2%; SM 89.6%), low referral (CM 42.4%; SM 36.3%) and attendance in primary care (CM 61.3%; SM 64.8%), and low attendance at all points of the health network (CM 18%; SM 21,8%), for both groups investigated. This study signals the importance of greater incentive to follow up on patients with multimorbidity in the especially in the post-discharge period, and the need for points of the Brazilian health network, in order to ensure the longitudinality and comprehensiveness of these patients.