O sistema hospitalar brasileiro e os hospitais de pequeno porte

• Autor(a) principal: Corrêa, Luciana Reis Carpanez
• Data de Publicação: 2019
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional do FGV (FGV Repositório Digital)
• Texto Completo: https://hdl.handle.net/10438/27493
• topic: Hospitals; Hospital legislation; Hospital bed size; National health policy; Hospitais; Legislação hospitalar; Tamanho dos hospitais; Políticas públicas de saúde; Administração de empresas; Hospitais - Brasil; Hospitais - Administração; Hospitais - Avaliação; Política de saúde - Brasil; Serviços de saúde - Brasil

Hospital care accounts for much of the increase in health care costs in recent years. Many countries have adapted their policies to the hospital sector, focusing attention on larger centers, after studies in the 1990s show that hospitals with less than 200 beds show reduced efficiency. The objective of this thesis was to understand how the Brazilian hospital park, in terms of size of hospitals, legal nature, national and bed distribution, hospital production (average stay indicators, occupancy rate, bed rotation rate, index the number of hospitalizations, the percentage of hospitalizations due to conditions sensitive to primary care, and the mortality rate, and the National Policy for Small Portholes Hospitals and their implications in the sector. the municipalities generated a reduction in hospital care, which was the method found by the municipal managers to meet health needs, with an increase in municipal hospitals, with a reduction in size, reaching the average of 50 beds / hospital. The reversal of this scenario involves complementary actions, that go through policies that induce hospital care qualification to the understanding that the almost 5,000 small hospital units in Brazil constitute a broad set to be studied in depth, subdividing it into smaller groups with different vocations. In a complex health system such as the Brazilian, measurements of national hospital production can help in the execution and direction of policies for the area. The results show that 83.5% of Brazilian hospitals received federal funding, most of them municipal, followed by philanthropic, private, state and federal. The hospitals with the highest proportion of hospitalizations were the philanthropic ones, followed by the state, municipal, private and federal hospitals. Small hospitals corresponded to 55.6% of hospitals but performed only 17.6% of hospitalizations. The medium-sized hospitals participate with 32.3% of the hospitals and 38.8% of the hospitalizations. Large hospitals correspond to 12.1% of hospitals and 43.6% of hospitalizations. The indicators analyzed showed a mean of 5-day stay, mean occupancy rate of 40%, bed-turning rate of 38 patients / bed / year (3 patients / bed / month). The mean time to bed occupancy after leaving a patient was 135 days (four and a half months) and 10% of hospitalizations occurred due to conditions sensitive to basic care. Finally, the analyzed indicators show that the higher the hospital size, the better the indicators of performance and efficiency. The data can subsidize policies for the health area with the objective of making the Brazilian hospital system more efficient and effective, corresponding better to the desires of the population they serve.