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The management of multidisciplinary care or patients with chronic disease O gerenciamento do cuidado multidisciplinar no acompanhamento de pacientes portadores de doen as cr nicas

DOI: 10.5712/rbmfc4(13)210

Keywords: Saúde Suplementar , Administra o dos Cuidados ao Paciente , Equipe de Assistência ao Paciente , Doen a Cr nica

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Abstract:

This study presents a health care program based on systemized multidisciplinary follow-up of 92 patients, carriers of chronic disease, with repeated hospital admissions and medical appointments and analyzes its results in terms of cost reduction for the health plan operator. The investigation covered a period of 12 months before introducing the program (10/01/2002 to 31/12/2002) and the same period after introducing the program (01/01/2003 to 31/12/2003). The results show a statistically significant reduction of appointments (from a mean of 15,39 to 9,58), hospital admissions (from 2,11 to 0,85), costs (from R$ 8.029,32 to R$ 3.054,03), as well as a decrease in hospital admissions due to the main disease (from 54 to 26) and to complications (from 55 to 38). Consequently, an equation establishing a mathematical model could be developed with the purpose of calculating the expenditure with the multidisciplinary care of a patient, allowing the health plan operator to conduct a strategic financial analysis for cost reduction. The established mathematical model is represented by the following equation: Y = 962 + 286 marital status - 1184 HA + 1070 admissions after + 84,3 appointments after - 621 caretaker before. The program improves the health of the patient and resultsin a significant reduction of the medical and hospital costs for the health plan operator. O estudo apresenta um modelo de assistência à saúde com base no acompanhamento sistematizado de equipe multidisciplinar a 92 pacientes portadores de doen a cr nica, com repetidas interna es e consultas médicas no período de 12 meses anteriores ao programa, e, em seguida, com a implanta o da metodologia por igual tempo, a análise dos resultados obtidos na redu o dos custos assistenciais para a operadora do plano de saúde. A investiga o foi realizada no período de 01 de janeiro de 2002 a 31 de dezembro de 2002 (sem aplica o do programa) e de 01 de janeiro de 2003 a 31 de dezembro de 2003 (com aplica o do programa). O trabalho mostra a redu o estatisticamente significativa das consultas (média de 15,39 para 9,58), das interna es (de 2,11 para 0,85), dos custos (de R$8.029,32 para R$3.054,03), das interna es por motivo de doen a principal (54 para 26) e, também, a diminui o das interna es devido a complica es da doen a (55 para 38). Como conseqüência, uma equa o que estabelece um modelo matemático p de ser desenvolvida, com a finalidade de se obter valor capaz de or ar uma despesa com assistência multidisciplinar daquele paciente, possibilitando um estudo estratégico financeiro para a operadora

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