Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/184670 |
Resumo: | OBJECTIVE To characterize the profile of patients hospitalized for mental and behavioral disorders by the Unified Health System (SUS) in Brazil between 2000 and 2014, and to verify how aspects of the new mental health policy influenced the rate of hospitalized patients in that period. METHODS Non-concurrent prospective cohort study using secondary data from inpatients with a primary diagnosis of mental and behavioral disorders between 01/01/2000 and 12/31/2014. Sociodemographic, clinical, and hospital characteristics variables were selected. Overall rates of hospitalized patients were calculated according to reason for admission, type of hospital, legal nature, and number of admissions per year for each patient. The association between rates of hospitalized patients, number of psychiatric beds per year, and number of Psychosocial Care Centers per year were tested. RESULTS We selected a total of 1,549,298 patients, whose most frequent diagnoses on first admission were psychoactive substance use disorders, followed by schizophrenia and mood disorders. The median of hospitalizations per patient was 1.9 and the length of stay per patient was 29 days. The overall rate of hospitalized patients was reduced by almost half in the period. The number of beds per year was positively associated with the rates of hospitalized patients; the number of CAPS per year was negatively associated with some rates of hospitalized patients. CONCLUSION Even in the face of adversity, the National Mental Health Policy has advanced in its goal of progressively reducing hospital beds and increasing the supply of substitute services such that both strategies were associated with the reduced inpatient rates. But the changes were felt with greater intensity in the first years of the policy’s implementation, becoming less pronounced in recent years. |
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Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014Psychiatric hospitalizations by the Unified Health System in Brazil between 2000 and 2014Mental disordersDay care, medicalHospitalizationCommitment of Mentally IllUnified Health SystemMental healthPublic health policyTranstornos mentaisHospital DiaHospitalizaçãoSistema Único de SaúdeSaúde mentalPolíticas públicas de saúdeOBJECTIVE To characterize the profile of patients hospitalized for mental and behavioral disorders by the Unified Health System (SUS) in Brazil between 2000 and 2014, and to verify how aspects of the new mental health policy influenced the rate of hospitalized patients in that period. METHODS Non-concurrent prospective cohort study using secondary data from inpatients with a primary diagnosis of mental and behavioral disorders between 01/01/2000 and 12/31/2014. Sociodemographic, clinical, and hospital characteristics variables were selected. Overall rates of hospitalized patients were calculated according to reason for admission, type of hospital, legal nature, and number of admissions per year for each patient. The association between rates of hospitalized patients, number of psychiatric beds per year, and number of Psychosocial Care Centers per year were tested. RESULTS We selected a total of 1,549,298 patients, whose most frequent diagnoses on first admission were psychoactive substance use disorders, followed by schizophrenia and mood disorders. The median of hospitalizations per patient was 1.9 and the length of stay per patient was 29 days. The overall rate of hospitalized patients was reduced by almost half in the period. The number of beds per year was positively associated with the rates of hospitalized patients; the number of CAPS per year was negatively associated with some rates of hospitalized patients. CONCLUSION Even in the face of adversity, the National Mental Health Policy has advanced in its goal of progressively reducing hospital beds and increasing the supply of substitute services such that both strategies were associated with the reduced inpatient rates. But the changes were felt with greater intensity in the first years of the policy’s implementation, becoming less pronounced in recent years.OBJETIVO Caracterizar o perfil dos pacientes que foram internados por transtornos mentais e comportamentais pelo Sistema Único de Saúde (SUS) no Brasil entre 2000 e 2014, bem como verificar como aspectos da nova política de saúde mental influenciaram a taxa de pacientes internados no referido período. MÉTODOS Estudo de coorte prospectiva não concorrente utilizando dados secundários de pacientes internados com diagnóstico primário de transtornos mentais e comportamentais entre 01/01/2000 e 31/12/2014. Foram selecionadas variáveis sociodemográficas, clínicas e de características do hospital, além disso, foram calculadas as taxas gerais de pacientes internados segundo motivo de internação, tipo de hospital, natureza jurídica e número de internações de cada paciente por ano. Foi testada a associação entre taxas de pacientes internados, número de leitos psiquiátricos por ano e número de Centros de Atenção Psicossocial por ano. RESULTADOS Foram selecionados 1.549.298 pacientes dos quais os diagnósticos mais frequentes na primeira internação foram os transtornos devidos ao uso de substâncias psicoativas, seguidos por esquizofrenia e transtornos de humor. A mediana de internações por paciente foi de 1,9 e a de tempo de internação por paciente foi de 29 dias. A taxa geral de pacientes internados foi reduzida à quase metade no período. O número de leitos por ano apresentou associação positiva com as taxas de pacientes internados, e o número de CAPS por ano teve associação negativa com algumas taxas de pacientes internados. CONCLUSÃO Verificou-se que, mesmo diante de um contexto de adversidades, a Política Nacional de Saúde Mental avançou em suas metas de reduzir progressivamente os leitos hospitalares e aumentar a oferta de serviços substitutivos de tal modo que ambas as estratégias foram associadas à redução das taxas de pacientes internados. Contudo, as mudanças foram percebidas com maior intensidade nos primeiros anos de implantação da política, tornando-se menos pujante nos últimos anos.Universidade de São Paulo. Faculdade de Saúde Pública2021-04-16info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/18467010.11606/s1518-8787.2021055002155Revista de Saúde Pública; Vol. 55 (2021); 14Revista de Saúde Pública; Vol. 55 (2021); 14Revista de Saúde Pública; v. 55 (2021); 141518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/184670/170847https://www.revistas.usp.br/rsp/article/view/184670/170846https://www.revistas.usp.br/rsp/article/view/184670/170845Copyright (c) 2021 Hugo André da Rocha, Ilka Afonso Reis, Marcos Antônio da Cunha Santos, Ana Paula Souto Melo, Mariangela Leal Cherchigliahttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessRocha, Hugo André da Reis, Ilka AfonsoSantos, Marcos Antônio da Cunha Melo, Ana Paula SoutoCherchiglia, Mariangela Leal 2021-04-22T15:40:37Zoai:revistas.usp.br:article/184670Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2021-04-22T15:40:37Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 Psychiatric hospitalizations by the Unified Health System in Brazil between 2000 and 2014 |
title |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 |
spellingShingle |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 Rocha, Hugo André da Mental disorders Day care, medical Hospitalization Commitment of Mentally Ill Unified Health System Mental health Public health policy Transtornos mentais Hospital Dia Hospitalização Sistema Único de Saúde Saúde mental Políticas públicas de saúde |
title_short |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 |
title_full |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 |
title_fullStr |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 |
title_full_unstemmed |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 |
title_sort |
Internações psiquiátricas pelo Sistema Único de Saúde no Brasil ocorridas entre 2000 e 2014 |
author |
Rocha, Hugo André da |
author_facet |
Rocha, Hugo André da Reis, Ilka Afonso Santos, Marcos Antônio da Cunha Melo, Ana Paula Souto Cherchiglia, Mariangela Leal |
author_role |
author |
author2 |
Reis, Ilka Afonso Santos, Marcos Antônio da Cunha Melo, Ana Paula Souto Cherchiglia, Mariangela Leal |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Rocha, Hugo André da Reis, Ilka Afonso Santos, Marcos Antônio da Cunha Melo, Ana Paula Souto Cherchiglia, Mariangela Leal |
dc.subject.por.fl_str_mv |
Mental disorders Day care, medical Hospitalization Commitment of Mentally Ill Unified Health System Mental health Public health policy Transtornos mentais Hospital Dia Hospitalização Sistema Único de Saúde Saúde mental Políticas públicas de saúde |
topic |
Mental disorders Day care, medical Hospitalization Commitment of Mentally Ill Unified Health System Mental health Public health policy Transtornos mentais Hospital Dia Hospitalização Sistema Único de Saúde Saúde mental Políticas públicas de saúde |
description |
OBJECTIVE To characterize the profile of patients hospitalized for mental and behavioral disorders by the Unified Health System (SUS) in Brazil between 2000 and 2014, and to verify how aspects of the new mental health policy influenced the rate of hospitalized patients in that period. METHODS Non-concurrent prospective cohort study using secondary data from inpatients with a primary diagnosis of mental and behavioral disorders between 01/01/2000 and 12/31/2014. Sociodemographic, clinical, and hospital characteristics variables were selected. Overall rates of hospitalized patients were calculated according to reason for admission, type of hospital, legal nature, and number of admissions per year for each patient. The association between rates of hospitalized patients, number of psychiatric beds per year, and number of Psychosocial Care Centers per year were tested. RESULTS We selected a total of 1,549,298 patients, whose most frequent diagnoses on first admission were psychoactive substance use disorders, followed by schizophrenia and mood disorders. The median of hospitalizations per patient was 1.9 and the length of stay per patient was 29 days. The overall rate of hospitalized patients was reduced by almost half in the period. The number of beds per year was positively associated with the rates of hospitalized patients; the number of CAPS per year was negatively associated with some rates of hospitalized patients. CONCLUSION Even in the face of adversity, the National Mental Health Policy has advanced in its goal of progressively reducing hospital beds and increasing the supply of substitute services such that both strategies were associated with the reduced inpatient rates. But the changes were felt with greater intensity in the first years of the policy’s implementation, becoming less pronounced in recent years. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-04-16 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/184670 10.11606/s1518-8787.2021055002155 |
url |
https://www.revistas.usp.br/rsp/article/view/184670 |
identifier_str_mv |
10.11606/s1518-8787.2021055002155 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/184670/170847 https://www.revistas.usp.br/rsp/article/view/184670/170846 https://www.revistas.usp.br/rsp/article/view/184670/170845 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf text/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 55 (2021); 14 Revista de Saúde Pública; Vol. 55 (2021); 14 Revista de Saúde Pública; v. 55 (2021); 14 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221801946546176 |