Readmissão no pronto socorro, um problema evitável? Análise e estratificação de readmissões em um centro de referência para trauma
Emergency room readmission, an avoidable problem? Analysis and stratification of readmissions in a trauma reference center
Eduardo Takemura Adania; Gilson Soares de Faria Junior; Nicole Rampani Franzoni; Silvania Klug Pimentel
Resumo
Introdução: A readmissão hospitalar é uma maneira comum de se avaliar a qualidade do atendimento prestado em um serviço de emergência. O objetivo deste estudo foi quantificar, estratificar e buscar possíveis fatores associados às readmissões de um serviço de emergência referência para atendimento ao trauma.
Métodos: Estudo longitudinal retrospectivo com pacientes admitidos, duas vezes ou mais, no pronto-socorro em um período máximo de 30 dias da admissão inicial - tendo sido internados ou não. Dados clínicos e demográficos foram obtidos a partir de prontuários eletrônicos.
Resultados: A taxa de readmissão do serviço foi de 4,11% para todas as readmissões e 2,23% para as readmissões evitáveis. Dentro desse grupo, 61,19% foram provavelmente evitáveis, 19,47% possivelmente evitáveis e 19,34% eventualmente evitáveis. Quanto ao tempo, 48,16% ocorreram em menos de uma semana da readmissão inicial. Além disso, não foi encontrada associação estatisticamente significativa na análise do sexo biológico, dos acidentes de trabalho e das comorbidades. Foi encontrada associação estatisticamente significativa na análise da idade e do transporte por ambulância (OR 1,37; IC 95% 1,17-1,59).
Conclusão: O estudo explicitou que há readmissões em pronto-socorro que poderiam ser evitadas, além de ter sido observada uma relação significativa entre as readmissões e a faixa etária, e o transporte por ambulância.
Palavras-chave
Abstract
Introduction: Hospital readmission is a common way to assess the quality of care provided in an emergency service. In this context, the aim of this study is to quantify and stratify readmissions in a trauma reference emergency service.
Methods: A retrospective longitudinal study was conducted with patients readmitted, twice or more, in the emergency service within a maximum period of 30 days from the initial admission - hospitalized or not. Clinical and demographic data were obtained from electronic medical records.
Results: The readmission rate for the service was 4.11% for all readmissions and 2.23% for avoidable readmissions. Within this group, 61.19% were likely avoidable, 19.47% possibly avoidable, and 19.34% eventually avoidable. Regarding time, 48.16% occurred within one week of the initial readmission. Furthermore, no statistically significant association was found in the analysis of biological sex, occupational accident, and comorbidities. A statistically significant association was found in the analysis of age and ambulance transport (OR 1.37; 95% CI 1.17-1.59).
Conclusion: The study highlighted that there are still readmissions in the emergency department that could be avoided. A significant relationship was observed between readmissions and patient ages, and ambulance transport.
Keywords
References
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Submitted date:
11/30/2023
Accepted date:
03/31/2024
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