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DESIGUALDADE NO TRATAMENTO À FRATURA PROXIMAL DE FÊMUR NO RIO DE JANEIRO
Alternative title
Treatment inequity in hip fractures in Rio de Janeiro Treatment inequity in hip fractures in Rio de JaneiroAuthor
Affilliation
Abstract in Portuguese
OBJETIVO: O objetivo deste trabalho é analisar a existência de variações na indicação terapêutica a pacientes com fratura proximal de fêmur entre os hospitais conveniados com o SUS e entre pacientes socialmente distintos.
MÉTODO: Foram analisados os dados do SIH-SUS dos hospitais do município do Rio de Janeiro, 1994-1995.
RESULTADO: A análise multivariada mostrou que as chances de cirurgia foram maiores para as mulheres (OR=1,53, IC95%1,18-1,99); menores para os hospitais federais (OR = 0,21, IC95% 0,10-0,41), estaduais (OR =0,07, IC95% 0,04-0,12) e municipais (OR=0,11, IC95% 0,07-0,18), em comparação com o hospital privado contratado pelo SUS; foram menores nas emergências (OR=0,31, IC95% 0,19-0,48); e foram maiores nos hospitais localizados em áreas mais privilegiadas (OR=1,68, IC95% 1,52-1,86).
CONCLUSÃO: A configuração dos mercados variou com o perfil dos hospitais e pacientes, e a indicação de cirurgia foi associada a fatores não relacionados com a necessidade, mostrando diferenças no acesso ao tratamento adequado
Abstract
Objective: The aim of this study was to
analyze the variations in the surgical use
of healthcare services for hip fracture patients,
and the occurrence of inequity in
the Rio de Janeiro Public Health Sector.
Methods: The Unified Health System Hospital
Information System data from hospital
records of Rio de Janeiro health services
between 1994 and 1995 were analyzed.
Results: Multivariate analysis showed that
women had a greater chance of surgery
(OR=1.53, CI95%1.18-199). The chances of
surgery were lower in federal hospitals
(OR=0.21, CI95% 0.10-0.41), state hospitals
(OR =0.07, CI95% 0.04-0.12), and city hospitals
(OR=0.11, CI95% 0.07-0.18), compared
with private hospitals hired by the SUS. The
chances of surgery were lower in emergency
departments (OR=0.31, CI95% 0.19-
0.48) and in hospitals located in less deprived
areas (OR=1.68, CI95% 1.52-1.86).
Conclusion: The variation in the hospital
market was related to patient and hospital
profiles, and the surgical treatment for hip
fracture was associated with factors unrelated
to need, showing differences in access.
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