Programa de SIAD/Home Care de um hospital naval distrital: uma ferramenta para a redução de custos

Abstract

The Integrated Service of Home Care (SIAD) of the Marine Health System (SSM) is a service composed of a multidisciplinary health team, responsible for the provision of home care, offered by Naval Hospitals, to patients who, due to functional limitations or Health problem, can not maintain follow-up in the Brazilian Navy outpatient clinics (BRASIL, 2012). In the Naval Hospital studied, the estimated cost of home care currently corresponds to 11.46% of the monthly budget limit with expenditures on Extra-Marine Health Organizations (OSE), however, expenses for referrals to SBI exceed those foreseen in the provisioning ceiling Monthly for this Military Organization, considering this amount of costs, the monthly expenditure on home care revolves around 3% of the total with this type of expense. According to these data, the present study was carried out to characterize the profile of the users that use SIAD seeking the understanding of the demands they present in relation to the offer of services, besides the survey of hospitalizations in OSE after joining the SIAD / HOME CARE and cost analysis in the provision of assistance with emphasis on the most prevalent pathologies, aiming finally to assess the contribution of the program in reducing health costs. According to these data, the present study was carried out to characterize the profile of the users that use SIAD seeking the understanding of the demands they present in relation to the offer of services, besides the survey of hospitalizations in OSE after joining the SIAD / HOME CARE and cost analysis in the provision of care with emphasis on the most prevalent pathologies, aiming finally to assess the contribution of the program in reducing health costs. Regarding the methodological method of this study, we chose to use the quantitative research, with a descriptive-explanatory approach, using retrospective means by medical files of the SIAD / HOME CARE program and the Regulation System. Regarding the data collection, this occurred in the period from January to May 2017 in the administrative sector of the SIAD / Home Care Program, in search of the list of current users, counted in 38 (36 in SIAD and two in Home Care), as Also the date of insertion of these in the program and individual pathological events that motivated the inclusion in the period from January 2016 to April 2017. Regarding hospitalizations in the internal environment, that is, in the hospital itself, a search was made for the availability of a history of hospitalizations by the Hospital Naval Division of Nursing; However the data were disregarded because there was no precise cost of the referred hospitalizations.Regarding the hospitalizations related to the external environment, characterized by the accreditation of institutions for the performance of medium and high complexity services, a history search was made in the SSM's own Regulation System, through Personal Identification Number (PIN) and files Of the Audit Service of Medical Accounts of the Hospital surveyed. The study shows that home care through the SIAD / HOME CARE Program proves the effectiveness of home care, helping to reduce the cost of the institution and, consequently, the quality of life and daily health demands of the users.