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Doctoral Thesis
DOI
https://doi.org/10.11606/T.6.2020.tde-14042020-123022
Document
Author
Full name
Maria Josefa Vilar Esteves
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 1999
Supervisor
Committee
Tancredi, Francisco Bernardini (President)
Campino, Antonio Carlos Coelho
Guimaraes, Cid
Malik, Ana Maria
Osmo, Andre Alexandre
Title in Portuguese
Fatores do processo de assistência médico-hospitalar que causam o incremento da permanência do paciente no hospital
Keywords in Portuguese
Assistência Hospitalar
Atrasos e Procedimentos
Tempo de Permanência
Abstract in Portuguese
O propósito deste estudo foi o desenvolvimento e aplicação de um instrumento que permitisse identificar e quantificar atrasos no processo de produção hospitalar responsáveis pelo incremento da permanência do paciente no hospital. Baseados na bibliografia consultada e em critérios gerais de programação hospitalar, elaboramos fluxogramas que nos permitiram evidenciar os pontos críticos que provocavam atrasos na dinâmica do processo de produção dos serviços. O instrumento foi aplicado nos serviços de cirurgia e medicina interna num hospital público, da Venezuela. A unidade de observação foi os pacientes internados nesses serviços, durante um período de quatro (4) meses. Os dados foram tratados com estatisticas paramétricas (média aritmética, mediana, moda, desvio padrão, variância, etc.) e através de um conjunto de constructos por meio da aplicação da análise multivariada seguindo o método fatorial. As médias de permanência para os serviços de cirurgia e medicina foram de 4,5 dias e de 8,2 dias, respectivamente.Os atrasos mais prolongados foram os do serviço de anatomia patológica, com 7,9 dias para as biópsias e 25 dias para as citologias. No serviço de cirurgia, os atrasos na permanência hospitalar foram decorrentes de uma combinação de fatores que tiveram uma ponderação similar. Para o serviço de medicina interna, os atrasos na permanência estiveram diferenciados por dois fatores associados às variáveis: diagnóstico por imagens, endoscopia, medicamentos, cirurgia, interconsultas e laboratório.
Title in English
Factors of the process of hospital care causing increased length of stay of patients
Keywords in English
Delays in Procedures
Hospital Services
Length of Stay
Abstract in English
The purpose of the study was the development and application of an instrument aimed at identifying and quantifying delays in the hospital production process causing the increase of the stay of patients into the hospital. Based on the biobliography and on general criteria hospital programming, flowcharts were designed which allowed us to show the turning points that might provoque delays in the dynamics of the process of production services. The instrument was applied in the surgery and internal medicina departments of a Venezuelan public hospital. The unit of observation were the patients admitted in those units, during a 4-monthperiod. The data were analysed through parametric statistics (arithmetic mean, median, mode, standard deviation, etc.) and through a handful of constructs by applying the multivariate analysis following the factorial method. The average stay for medicine and surgery were 4.5 and 8.2 days respectively. The most prolonged delays were in the pathology service, with 7.9 days for biopsies and 25 days for cytologies. In the department of surgery, the delays in the hospital stay depended on a combination of factors which had a similar consideration. Regarding the internal medicine service, the stay delays differed in two factors associated to the variables: diagnosis through images, endoscopy, supply of drugs, surgical procedures, interconsultation and laboratory.
 
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Publishing Date
2020-04-14
 
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