Assistência domiciliar a idosos: fatores associados, características do acesso e do cuidado

Abstract

OBJECTIVE:To assess factors associated with home health care for the elderly and its characteristics based on different care models, the Family Health Strategy and traditional primary care. METHODS:A population-based cross-sectional study was conducted in a representative sample of 1,593 individuals aged ≥60 years living in the urban area of the city of Bagé, Southern Brazil, in 2008. A multistage sampling was carried out. Data was collected during individual interviews about access to services, providers' involvement, users' satisfaction and health status after care. Poisson regression model was used for estimating crude and adjusted prevalence ratios, their related 95% confi dence intervals and p-values (Wald test). RESULTS:Home health care was statistically associated with prior history of stroke, signs of dementia and disability in activities of daily living. The family was requested 75% of home care visits. Medical doctors provided most of the care in traditional primary care settings while nursing staff provided most care within the Family Health Strategy. Approximately 78% of the elderly received care within 24 hours after the request and 95% of them positively evaluated the care received. Two thirds of the elderly reported improved health status. CONCLUSIONS:The variables associated with home health care were consistent with fragility indicators included in the Brazilian National Health Policy for the Elderly, reinforcing the role of this strategy for promoting equitable health care to elderly population. Users' satisfaction and the positive impact on their health status confi rm home as a setting for providing care.

Prevalência da assistência domiciliar prestada à população idosa brasileira e fatores associados

“…Entretanto, estudos de prevalên-cia ainda são escassos e os valores observados mostram grande variabilidade regional. Em um trabalho realizado em 2005, com 4.006 idosos em 41 municípios das regiões Sul e Nordeste, o recebimento de atenção domiciliar variou de 3% a 20%, com as melhores coberturas observadas em áreas da Estratégia Saúde da Família (ESF) 14,15,16 .…”

“…A prevalência de atenção domiciliar foi objeto de estudos regionais verificando uma variação entre 3% e 28%, dependendo de características do modelo assistencial e da região do país 14,15,16 .…”

Índice de vulnerabilidade a incapacidades e dependência (IVF-ID), segundo condições sociais e de saúde

“…The likelihood of receiving home care was 3.2 times higher in the IADL 14 . Regarding CNCDs, a study published in the Lancet in 2011 2 , indicated that the morbidity and mortality of these diseases was higher in the poor population.…”

Fatores associados à atenção domiciliária: subsídios à gestão do cuidado no âmbito do SUS

“…The social, family and clinical profi le of the user in HC translates the situa on of the elderly popula on that is served by UHS, characterized by: low educa on and income, generally women, with mobility problems, chronic degenera ve health problems, dependence for ADLs that demand care at home from family, some mes genera ng dynamic tensions in the home (5,(18)(19)(20) .…”

“…A change in the way services are organized is based on the health needs of the popula on, or what it manages to base on studies of the demand for health services (3)(4)(5) , is a premise for structuring the HCN from a basis in Primary Care, as the organizing center of care (6) .…”