Risco de hospitalização repetida em idosos atendidos na atenção primária de saúde de João Pessoa, Paraíba

Abstract

The complex process of population aging occurs concomitantly to the epidemiological transition that modifies the profile and the demand for health services, making the country a scenery of high mortality due to infectious diseases acute, to a reality of excessive spending on hospital admissions, especially for chronic conditions. The hospitalization of the elderly generates several consequences that directly affect their functionality and quality of life. For this reason, it is important to stratify the risk of hospitalization in elderly individual, with a view to improving the organization of care for their health. Objective: to analyze the risk for repeated hospitalization of elderly patients in Primary Care of Joao Pessoa, Paraiba. Materials and methods: this is a descriptive, cross-sectional, with a quantitative approach, performed at home for elderly enrolled in ESF in the city of Joao Pessoa, Paraiba. The sample was composed of 368 individuals aged 60 years or more.The data collection took place in the period of February to July 2014, by means of the technique of structured interview, subsidised by instrument that addressed sociodemographic and clinical variables, in addition to the Probability of Repeated Admission (PRA).For data analysis we used the Logistic Regression model with the variables of the PRA, which generated the risk stratification of hospitalization. To verify the association between the risk of hospitalization and the other variables we used the chi-square test of association, the Mantel-Haenszel test, and Correspondence Analysis. Results: it was found that 75% of the elderly respondents evidenced low risk for hospitalization repeated, 16% had medium risk, 6.3% medium risk-high and 2.7% showed high risk.Of the elderly who were found to be at high risk for hospitalization, the predominant those female, age range between 60-74 years; with self-perception of health as average; with a hospitalization in the last year and more than six medical consultations in the last twelve months; who were diabetics; and that already had cardiovascular disease. The present study also revealed, association statistically significant between the increase of risk with the variables: depression, ischemia, increase in the number of morbidity self-referred, widowhood and black. Conclusion: the results reinforce the need to adopt measures to classify the elderly at risk strata for hospitalization, in order to organize the entrance door, structuring the queues of access to health services and prioritise the care, that generates improvement for the health of the elderly patient and lower costs with hospitalization for the health sector.