Fatores de risco associados às internações hospitalares de crianças e adolescentes com doença crônica: aplicação de um modelo de decisão

Abstract

Chronic disease in childhood and adolescence usually causes changes in the normal growth and development of the child, in the same way, in their social relations, besides their family that undergoes several changes. When there are frequent hospitalizations, family suffering increases, as does a high cost to the health system, which in many cases care could be prevented at the primary care level. Considering that the hospitalization frequency influences the life of this public and can raise the costs of the health system, the present study aims to: analyze the risk factors associated with the frequency of hospitalization of children and adolescents with chronic disease, from of the SICADC (Information System for Children of Adolescents with Chronic Diseases) database. This is a cross-sectional observational, analytical, and exploratory study. Data collection was done from a set of secondary data, whose study population were children and adolescents with diagnosis of disease or chronic condition, registered in said database. The results were analyzed by binary logistic regression and, later, it was applied to Odds Ratio and the construction of a decision tree, to support decision making. Statistical significance was observed in the odds ratios for the following variables: motor deficiency, sequelae / damage due to illness, child / adolescent being in the chronic phase of the disease, restriction of physical activity, self-care, having caregivers in the marital status of the bachelors, family involvement in care, support and emotional support, change in the routine of the family, hospitalization for the examination and the hospital as a first service. For the decision tree model, the variables influencing hospitalizations were: motor deficiency, sequelae / damage due to illness, drug treatment, complex care, second disease, caregiver being included in the group of adults and/or working. Therefore, it was possible to observe that some variables are not compatible with the literature but were statistically significant. It is concluded that, when knowing the dimension of the problem of patients with chronic diseases in children and adolescents and the variables involved in the results of the present study can contribute to a better planning of actions aimed at the health care of this population, favoring the reduction of hospitalizations and the prolonged hospitalization time, thus being an aid in the decision-making process of the manager.