Avaliação da relação entre volume de procedimentos e a qualidade do cuidado: o caso de cirurgia coronariana no Brasil

Abstract

There is often a negative association between the volume of medical procedures and hospital mortality rates. The objective of this study is to determine whether this association is observed in

O Sistema de Informação Hospitalar e sua aplicação na saúde coletiva

“…Ao todo, sete estudos investigaram os fatores explicativos das variações na taxa de mortalidade hospitalar. O trabalho de Martins 58 , que observou que as marcadas diferenças da mortalidade entre os hospitais são explicadas em parte pela gravidade dos casos, após ajuste para idade e perfil clínico (case mix); o de Noronha et al 59 , que examinaram como o volume de cirurgias de revascularização do miocárdio (CRM) poderia afetar o risco de morrer, ajustado por idade, sexo e dias na unidade de tratamento intensivo (UTI); e o de Schramm 50 cuja análise permitiu classificar os hospitais segundo o risco materno e os resultados da assistência, e, assim, pô-de identificar hospitais alvos de ações da vigilância de serviços.…”

Letalidade e complicações da cirurgia de revascularização miocárdica no Rio de Janeiro, de 1999 a 2003

“…22 In Iran, Karimi et al 13 , from the Thoracic Surgery Society in the United States, reported on the correlation between volume and mortality of CABG: when the number of surgeries per hospital was lower than 100 procedures/year, the mortality rate was 5.0%, whereas when the number was higher, mortality was 3.2%. 24 In Brazil, from 1996 to 1998, by reviewing AIHs, Noronha et al 25 observed a CABG mortality rate of 7.2%. When the number of surgeries per institution was higher than 600 or lower than 151 procedures within three years, the mortality rates ranged from 5.81% to 9.00%, respectively.…”

“…When the number of surgeries per institution was higher than 600 or lower than 151 procedures within three years, the mortality rates ranged from 5.81% to 9.00%, respectively. 25 There are reports of differences in the outcomes of CABG between genders. Mortality was higher among women.…”

Clinical evolution of patients hospitalized due to the first episode of Acute Coronary Syndrome

“…Hospital mortality after CABG, on the other hand, was 20% higher than in other institutions (13,16,(19)(20) . A Brazilian nationwide study identified a rate of 7.2% (21) . In Rio de Janeiro, adjusted mortality levels at the research hospitals ranged between 1.9% and 11.2% (19) .…”