Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015)
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://www.scopus.com/inward/record.url?scp=85070722543&partnerID=8YFLogxK |
Resumo: | Introduction: Due to epidemiological change, interest in complex chronic conditions has been increasing within the pediatric health system. As such, we aim to evaluate hospital inpatient care in the National Health Service (mainland Portugal) by pediatric patients (0 – 17 years) with complex chronic conditions. Material and Methods: Observational longitudinal retrospective epidemiological study using anonymized administrative data. We selected hospitalizations within the pediatric age limit, 2011 – 2015; healthy newborns and radiotherapy outpatients were excluded. A descriptive analysis of the admissions with complex chronic conditions was analysed by number of complex chronic conditions categories and by complex chronic conditions categories. Non-parametric tests were applied to length of stay, expense, and mortality. Results: Out of 419 927 admissions, 64 918 (15.5%) contained at least one complex chronic conditions code. These admissions due to complex chronic conditions represented 29.8% of hospital days, 39.4% of expense and 87.2% of deaths. Compared to those without complex chronic conditions, expense was double (median €1467 vs €745) and mortality 40 times higher (2.4% vs 0.06%). Of these, 46% were planned (no complex chronic conditions 23.2%); 64.8% occurred in group III – IV hospitals (no complex chronic conditions 27.1%). Malignant was the most frequent category (23.0%); neonatal had the highest median length of stay (12 days, 6 – 41), median expense (€3568,929 – 24 602), and number of deaths (43.5% of total). Discussion: As in other developed countries where the number of pediatric admissions is decreasing, in mainland Portugal we found an increase in the proportion of complex chronic conditions admissions, which are longer, costlier and deadlier (trends intensified in the presence of two or more complex chronic conditions categories). Conclusion: Complex chronic conditions are relevant in the activity and costs regarding pediatric hospitalizations in mainland Portugal. Recognizing this and integrating pediatric palliative care from the moment of diagnosis are essential to promote appropriate hospital use, through the development of effective and sustainable alternatives that meet the needs of children, families, and healthcare professionals. |
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Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015)Hospital inpatient use in mainland Portugal by children with complex chronic conditions (2011 – 2015)ChildHospitalizationNeeds assessmentPalliative carePortugalMedicine(all)Introduction: Due to epidemiological change, interest in complex chronic conditions has been increasing within the pediatric health system. As such, we aim to evaluate hospital inpatient care in the National Health Service (mainland Portugal) by pediatric patients (0 – 17 years) with complex chronic conditions. Material and Methods: Observational longitudinal retrospective epidemiological study using anonymized administrative data. We selected hospitalizations within the pediatric age limit, 2011 – 2015; healthy newborns and radiotherapy outpatients were excluded. A descriptive analysis of the admissions with complex chronic conditions was analysed by number of complex chronic conditions categories and by complex chronic conditions categories. Non-parametric tests were applied to length of stay, expense, and mortality. Results: Out of 419 927 admissions, 64 918 (15.5%) contained at least one complex chronic conditions code. These admissions due to complex chronic conditions represented 29.8% of hospital days, 39.4% of expense and 87.2% of deaths. Compared to those without complex chronic conditions, expense was double (median €1467 vs €745) and mortality 40 times higher (2.4% vs 0.06%). Of these, 46% were planned (no complex chronic conditions 23.2%); 64.8% occurred in group III – IV hospitals (no complex chronic conditions 27.1%). Malignant was the most frequent category (23.0%); neonatal had the highest median length of stay (12 days, 6 – 41), median expense (€3568,929 – 24 602), and number of deaths (43.5% of total). Discussion: As in other developed countries where the number of pediatric admissions is decreasing, in mainland Portugal we found an increase in the proportion of complex chronic conditions admissions, which are longer, costlier and deadlier (trends intensified in the presence of two or more complex chronic conditions categories). Conclusion: Complex chronic conditions are relevant in the activity and costs regarding pediatric hospitalizations in mainland Portugal. Recognizing this and integrating pediatric palliative care from the moment of diagnosis are essential to promote appropriate hospital use, through the development of effective and sustainable alternatives that meet the needs of children, families, and healthcare professionals.Centro de Investigação em Saúde Pública (CISP/PHRC)Escola Nacional de Saúde Pública (ENSP)RUNLacerda, Ana ForjazOliveira, GraçaCancelinha, CândidaLopes, Sílvia2019-11-26T23:25:53Z2019-07-012019-07-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article11application/pdfhttp://www.scopus.com/inward/record.url?scp=85070722543&partnerID=8YFLogxKpor0870-399XPURE: 15589327http://www.scopus.com/inward/record.url?scp=85070722543&partnerID=8YFLogxKinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:39:22Zoai:run.unl.pt:10362/88515Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:36:51.700112Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) Hospital inpatient use in mainland Portugal by children with complex chronic conditions (2011 – 2015) |
title |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) |
spellingShingle |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) Lacerda, Ana Forjaz Child Hospitalization Needs assessment Palliative care Portugal Medicine(all) |
title_short |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) |
title_full |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) |
title_fullStr |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) |
title_full_unstemmed |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) |
title_sort |
Utilização do internamento hospitalar em Portugal continental por crianças com doenças crónicas complexas (2011 – 2015) |
author |
Lacerda, Ana Forjaz |
author_facet |
Lacerda, Ana Forjaz Oliveira, Graça Cancelinha, Cândida Lopes, Sílvia |
author_role |
author |
author2 |
Oliveira, Graça Cancelinha, Cândida Lopes, Sílvia |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Centro de Investigação em Saúde Pública (CISP/PHRC) Escola Nacional de Saúde Pública (ENSP) RUN |
dc.contributor.author.fl_str_mv |
Lacerda, Ana Forjaz Oliveira, Graça Cancelinha, Cândida Lopes, Sílvia |
dc.subject.por.fl_str_mv |
Child Hospitalization Needs assessment Palliative care Portugal Medicine(all) |
topic |
Child Hospitalization Needs assessment Palliative care Portugal Medicine(all) |
description |
Introduction: Due to epidemiological change, interest in complex chronic conditions has been increasing within the pediatric health system. As such, we aim to evaluate hospital inpatient care in the National Health Service (mainland Portugal) by pediatric patients (0 – 17 years) with complex chronic conditions. Material and Methods: Observational longitudinal retrospective epidemiological study using anonymized administrative data. We selected hospitalizations within the pediatric age limit, 2011 – 2015; healthy newborns and radiotherapy outpatients were excluded. A descriptive analysis of the admissions with complex chronic conditions was analysed by number of complex chronic conditions categories and by complex chronic conditions categories. Non-parametric tests were applied to length of stay, expense, and mortality. Results: Out of 419 927 admissions, 64 918 (15.5%) contained at least one complex chronic conditions code. These admissions due to complex chronic conditions represented 29.8% of hospital days, 39.4% of expense and 87.2% of deaths. Compared to those without complex chronic conditions, expense was double (median €1467 vs €745) and mortality 40 times higher (2.4% vs 0.06%). Of these, 46% were planned (no complex chronic conditions 23.2%); 64.8% occurred in group III – IV hospitals (no complex chronic conditions 27.1%). Malignant was the most frequent category (23.0%); neonatal had the highest median length of stay (12 days, 6 – 41), median expense (€3568,929 – 24 602), and number of deaths (43.5% of total). Discussion: As in other developed countries where the number of pediatric admissions is decreasing, in mainland Portugal we found an increase in the proportion of complex chronic conditions admissions, which are longer, costlier and deadlier (trends intensified in the presence of two or more complex chronic conditions categories). Conclusion: Complex chronic conditions are relevant in the activity and costs regarding pediatric hospitalizations in mainland Portugal. Recognizing this and integrating pediatric palliative care from the moment of diagnosis are essential to promote appropriate hospital use, through the development of effective and sustainable alternatives that meet the needs of children, families, and healthcare professionals. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-11-26T23:25:53Z 2019-07-01 2019-07-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://www.scopus.com/inward/record.url?scp=85070722543&partnerID=8YFLogxK |
url |
http://www.scopus.com/inward/record.url?scp=85070722543&partnerID=8YFLogxK |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
0870-399X PURE: 15589327 http://www.scopus.com/inward/record.url?scp=85070722543&partnerID=8YFLogxK |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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11 application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799137986198110208 |