Acessibilidade à assistência fisioterapêutica de pacientes que tiveram Covid-19

Abstract

Introduction: The pandemic caused by COVID-19 caused an increase in the demand for hospitalization and physical therapy assistance. However, after hospital discharge, these subjects may require continued physical therapy care, as this infection has a severe impact on the body. Given the demands for physical therapy care that the Sars-Cov-2 virus has caused, this study aims to: analyze the accessibility to physical therapy care by patients who had COVID-19. Methodology: this is a cross-sectional study with data triangulation, carried out at a university hospital, using the registry of 73 health records of individuals over 18 years of age who had COVID-19 and were discharged from the hospital. Data collection took place in three stages: document analysis, structured interview via telephone call and in-depth interview with the health manager. The analysis of data referring to health records used the statistical model WoE and Odds Ratio, with a significance level of 0.05; data on accessibility were organized according to the flow of events proposed by Frenk (1992), Multiple Correspondence Analysis (ACM) and content analysis for the interview with the (manager). Results: The most common symptoms were fever, cough and dyspnea; the median length of stay was 14 days, males were more likely to remain hospitalized for more days, and 92% of participants required ventilatory support. The WoE Model showed that the classification of physical therapy, place of admission, number of days on ventilatory support, alveolar recruitment and airway aspiration had greater weight compared to the length of hospital stay; 82.9% of subjects reported some type of complaint or limitation after hospital discharge, however, only 20% managed to access physical therapy care. The ACM pointed out that there was a gap between patients with risk factors (greater severity) of the vector position of the subjects who managed to access, which suggests difficulty in accessibility. The interview with the manager explained the emphasis on guaranteeing hospital care, making it difficult for users to continue providing physical therapy care after hospital discharge. Conclusion: It was found that after hospital discharge, the subjects had difficulties to obtain access to physical therapy services, with the aggravating factor that most of them did not receive a referral at the time of discharge. It was evident that the variables related to the clinical profile showed a greater influence on the outcome length of stay than the physical therapy assistance provided during hospitalization.