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  • 1
    In: Revista de Saúde Pública, Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais, Vol. 53 ( 2019-02-07), p. 64-
    Abstract: OBJECTIVE: To analyze the impact of the Hospital-Acquired Conditions (HAC) in women in the puerperal and pregnancy cycle during length of stay. METHODS: This cross-sectional study was conducted with 113,456 women, between July 2012 and July 2017, in Brazil’s national hospitals of the supplementary healthcare networks and philanthropists accredited to the Unified Health System (SUS). Data on hospital discharges were collected using the Diagnosis-Related Groups (DRG Brasil) system. All DRGs of the major diagnostic category 14 (MDC14), including pregnancy, childbirth and puerperium, were included. The impact of HAC on length of stay was estimated by Student’s t-test, and the effect size by Cohen’s d, which allows to assess clinical relevance. RESULTS: The most prevalent diagnostic categories related to MDC14 were vaginal and cesarean deliveries without complicating diagnoses, both at institutions accredited to SUS and those for supplementary health care. The prevalence of HAC was 3.8% in supplementary health and 2.5% in SUS. Hospitals providing services to supplementary health care providers had a longer length of stay considering HAC for patients classified as DRG: cesarean section with complications or comorbidities at admission (p 〈 0.001; Cohen’s d = 0.74), cesarean section without complications or comorbidities at admission (p 〈 0.001, Cohen’s d = 0.31), postpartum and post abortion without listed procedure (p 〈 0.001, Cohen’s d = 1.05), and other antepartum diagnoses with medical complications (p 〈 0.001; Cohen’s d = 0.77). CONCLUSIONS: This study showed that the prevalence of HAC was low both in the institutions accredited to attend by SUS and in those of supplementary health; however, its presence contributes to increasing the length of stay in cases of cesarean sections without complications or comorbidities in supplementary health institutions.
    Type of Medium: Online Resource
    ISSN: 1518-8787 , 0034-8910
    Language: Unknown
    Publisher: Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais
    Publication Date: 2019
    detail.hit.zdb_id: 2031055-9
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  • 2
    In: Revista de Saúde Pública, Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais, Vol. 53 ( 2019-02-07), p. 65-
    Abstract: OBJECTIVE: To evaluate whether age group, complications or comorbidities are associated with the length of hospitalization of women undergoing cesarean section. METHODS: A cross-sectional study was carried out between June 2012 and July 2017, with 64,437 women undergoing cesarean section and who did not acquire conditions during their hospital stay. Hospital discharge data were collected from national health institutions, using the Diagnosis-Related Groups system (DRG Brasil). The DRG referring to cesarean section with additional complications or comorbidities (DRG 765) and cesarean section without complications or associated comorbidities (DRG 766) were included in the initial diagnosis. The influence of age group and comorbidities or complications present at admission on the length of hospital stay was assessed based on the means of the analysis of variance. The size of the effect was verified by Cohen’s D, which allows evaluating clinical relevance. The criticality levels were identified using the Duncan test. RESULTS: The longest length of hospital stay was observed in the age group from 15 to 17 years old and among those aged 45 years old or more. The hospital stay of women with complications or comorbidities at the time of admission was also longer. Moreover, it was noted that the increase in criticality level was associated with an increase in the mean length of hospital stay. CONCLUSIONS: The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.
    Type of Medium: Online Resource
    ISSN: 1518-8787 , 0034-8910
    Language: Unknown
    Publisher: Universidade de São Paulo. Agência de Bibliotecas e Coleções Digitais
    Publication Date: 2019
    detail.hit.zdb_id: 2031055-9
    Location Call Number Limitation Availability
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  • 3
    In: Revista Brasileira de Enfermagem, FapUNIFESP (SciELO), Vol. 73, No. suppl 4 ( 2020)
    Abstract: RESUMEN Objetivos: investigar los factores asociados con la ruta de nacimiento en mujeres embarazadas en la ciudad de Belo Horizonte. Métodos: estudio transversal desarrollado con datos de la investigación “Nacer en Belo Horizonte: Encuesta sobre el parto y el nacimiento”, realizada en siete hospitales de maternidad en Belo Horizonte - Minas Gerais. La muestra final consistió en 1088 mujeres embarazadas/postparto. En este estudio, para verificar la magnitud de la asociación entre la variable de resultado y sus posibles determinantes (variables de exposición), se construyeron modelos de regresión logística para estimar el Odds Ratio. Resultados: el aumento de la edad, la ausencia de un acompañante, la financiación privada del hospital para el parto y el hecho de ser una mujer embarazada por primera vez aumentaron las posibilidades de tener una ruta de parto por cesárea. Consideraciones Finales: el conocimiento de los factores asociados con la prevalencia de cesáreas puede apoyar las reflexiones entre los profesionales de la salud sobre este procedimiento quirúrgico en ciertas situaciones, especialmente cuando no hay indicaciones clínicas precisas.
    Type of Medium: Online Resource
    ISSN: 1984-0446 , 0034-7167
    Language: English
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2020
    detail.hit.zdb_id: 2399925-1
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