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Advisor(s)
Abstract(s)
Introdução: A avaliação económica de tecnologias da saúde (TS) é um factor estratégico na organização dos cuidados e gestão racional dos recursos. Em Portugal, na área da terapia e reabilitação, a avaliação das TS é ainda relativamente incipiente, nomeadamente na área do AVC e nas respostas de cuidados de saúde no percurso hospitalar do doente. Este estudo tem como objectivos: (1) Descrever e caracterizar o percurso do doente vítima de Acidente Vascular Cerebral (AVC) num Centro Hospitalar (CH) ao longo de um ano (2014-2015), desde a admissão pela Via Verde do Acidente Vascular Cerebral (AVC) no CH à luz dos indicadores, com análise dos custos globais do doente; (2) Caracterizar os cuidados de reabilitação prestados, incluindo uma análise dos custos de reabilitação destes doentes neste contexto e (3) Caracterizar a atividade levada a cabo por terapeutas da fala, com a descrição de indicadores de atividade e unidades de medida e avaliação dos custos, e dos custos unitários. Metodologia: Trata-se de um estudo piloto e exploratório, descritivo quantitativo, retrospectivo e longitudinal, ao longo do ano 2014-2015. A origem e recolha de dados foi a base de dados estatísticos do CH. A amostra são 26 pessoas (18 homens e 8 mulheres) com AVC que foram admitidos pela Via Verde do AVC nos meses de Janeiro e Julho de 2014 de quem se analisou os dados do registo informático dos seus percursos no contínuo de cuidados hospitalares por um período de 12 meses. Resultados: Os sujeitos estiveram internados uma média de 22 dias (DP±34) Após alta 54% foram para outro hospital. O valor médio GDH por doente foi de 14519,24€ para uma média de 17 dias de internamento, representando um valor médio dia por doente de aproximadamente 863,85 euros. O valor total dos MCDT foi de 97894,90€, o valor total dos MCDT de Reabilitação foi de 26852,10€ e o valor total dos actos de diagnóstico e terapêutica de Terapia da fala foi de 3127,80€. Conclusão: O tempo de internamento é determinante no aumento dos custos dos cuidados. Os custos de reabilitação no internamento, principalmente, e no ambulatório são uma parte significativa dos custos totais do percurso do doente.
ABSTRACT - Introduction: Economic assessment of health technologies HTA) is a strategic factor in the organization of care and rational management of resources. In Portugal, in the area of therapy and rehabilitation, HTA are still relatively incipient, namely in the area of stroke and health care responses in the patient's hospital pathway. This study aims to: (1) Describe and characterize the care pathway of stroke victims in a central hospital (CH) over a year (2014-2015), since the admission by the Via Verde of the Stroke in the CH in regard of indicators, with analysis of overall patient costs; (2) Characterize the rehabilitation care provided, including an analysis of the rehabilitation costs of these patients in this context; and (3) Characterize the activity carried out by speech therapists, describing activity indicators and units of measurement and costs, and unit costs. Methodology: This is a pilot and exploratory study, descriptive quantitative, retrospective, and longitudinal, during the year 2014-2015. The source and data collection was the CH statistical database. The sample is 26 people (18 men and 8 women) with stroke who were admitted by the Via Verde of the stroke in the months of January and July 2014 who analyzed the data from the computer record of their pathways in the hospital care continuum for a period of 12 months. Results: The subjects were hospitalized for an average of 22 days (SD ± 34). After discharge, 54% went to another hospital. The average GDH value per patient was € 14519.24 for an average of 17 days of hospitalization, representing an average daily value per patient of approximately € 863.85. The total value of the MCDT was € 97894,90, the total value of the Rehabilitation MCDT was € 26 852,10 and the total value of the speech therapy diagnosis and therapy acts was € 3 127,80. Conclusion: The length of stay is crucial in increasing the costs of care. Inpatient and outpatient rehabilitation costs are a significant part of the patient's total journey costs.
ABSTRACT - Introduction: Economic assessment of health technologies HTA) is a strategic factor in the organization of care and rational management of resources. In Portugal, in the area of therapy and rehabilitation, HTA are still relatively incipient, namely in the area of stroke and health care responses in the patient's hospital pathway. This study aims to: (1) Describe and characterize the care pathway of stroke victims in a central hospital (CH) over a year (2014-2015), since the admission by the Via Verde of the Stroke in the CH in regard of indicators, with analysis of overall patient costs; (2) Characterize the rehabilitation care provided, including an analysis of the rehabilitation costs of these patients in this context; and (3) Characterize the activity carried out by speech therapists, describing activity indicators and units of measurement and costs, and unit costs. Methodology: This is a pilot and exploratory study, descriptive quantitative, retrospective, and longitudinal, during the year 2014-2015. The source and data collection was the CH statistical database. The sample is 26 people (18 men and 8 women) with stroke who were admitted by the Via Verde of the stroke in the months of January and July 2014 who analyzed the data from the computer record of their pathways in the hospital care continuum for a period of 12 months. Results: The subjects were hospitalized for an average of 22 days (SD ± 34). After discharge, 54% went to another hospital. The average GDH value per patient was € 14519.24 for an average of 17 days of hospitalization, representing an average daily value per patient of approximately € 863.85. The total value of the MCDT was € 97894,90, the total value of the Rehabilitation MCDT was € 26 852,10 and the total value of the speech therapy diagnosis and therapy acts was € 3 127,80. Conclusion: The length of stay is crucial in increasing the costs of care. Inpatient and outpatient rehabilitation costs are a significant part of the patient's total journey costs.
Description
Mestrado em Gestão e Avaliação de Tecnologias em Saúde
Keywords
AVC Custos na saúde Avaliação económica Medicina de reabilitação Stroke Health costs Economic evaluation Rehabilitation Portugal Centro Hospitalar de Lisboa Central
Citation
Carvalhal AH. Percurso do doente com AVC no CHULC e análise de custos: gestão de recursos, indicadores de atividades, unidades de medida e custos unitários [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; Escola Superior de Saúde da Universidade do Algarve; 2019.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa