ABSTRACT
INTRODUCCIÓN: las actividades asistenciales relacionadas con la atención de pacientes en servicios clínicos tienen diferentes grados de riesgos para las personas que los reciben, el error en la atención sanitaria se denomina evento adverso y/o centinelas los que, según su gravedad, pueden llegar a causar la muerte de los usuarios. OBJETIVO: determinar los costos totales de úlceras por presión y caídas ocurridos en los usuarios de los servicios clínicos de cirugía y medicina en un establecimiento de alta complejidad durante el primer semestre del 2017 y primer semestre del 2018, en Chile. MÉTODO: estudio descriptivo retrospectivo. La ocurrencia de eventos relacionados a úlceras por presión y caídas son notificados a través del sistema informático Phoenix y son recepcionados por el Departamento de Calidad y Seguridad del Paciente del establecimiento, los datos económicos fueron proporcionados por el departamento de Finanzas. Los datos fueron procesados por programa computacional Excel. RESULTADOS: los costos totales asociado a úlceras por presión y caídas:ï¼Servicio de Cirugía, primer semestre del 2017:-Ulceras por presión $44.086.872 (U$ 57.557 dólares)-Caídas $39.630.517 (U$51.739 dólares)-Costo total $ 83.717.389 (U$109.297 dólares)ï¼Servicio de Medicina, primer semestre del 2017:-Úlceras por presión $22.654.894 (U$29.803 dólares)-Caídas $32.023.185 (U$41.807 dólares)-Costo total $ 54.678.079 (U$71.385 dólares)ï¼Servicio de Cirugía, primer semestre del 2018:-Ulceras por presión $76.979.440 (U$100.500 dólares)-Caídas $18.522.927 (U$24.182 dólares)-Costo total $ 95.502.367 (U$124.683 dólares)ï¼Servicio de Medicina, primer semestre del 2018:-Ulceras por presión $14.981.255 (U$19.558 dólares)-Caídas $55.258.625 (U$72.142 dólares)-Costo total $ 70.239.880 (U$91.701 dólares) CONCLUSIÓN: se logró levantar información actual sobre los recursos financieros y clínicos que determinan el impacto económico que generan los eventos adversos en los pacientes atendidos en un centro asistencial público. Es por esto, que el presente estudio, permitió cuantificar y evidenciar el impacto económico de dos eventos ocurridos en los servicios clínicos de un hospital de alta complejidad de Chile.
INTRODUCTION: healthcare activities related to the care of patients in clinical services, have different degrees of risks for the people who receive them, the error in health care is called an adverse event and / or sentinels which, depending on their severity, can arrive to cause the death of users. OBJECTIVE: to determine the total costs of pressure ulcers and falls that occurred in users of clinical services of surgery and medicine in a highly complex establishment during the first half of 2017 and the first half of 2018, in Chile. METHOD: retrospective descriptive study. The occurrence of events related to pressure ulcers and falls are notified through the Phoenix computer system and are received by the Department of Quality and Patient Safety of the establishment, the economic data were provided by the Department of Finance. The data were processed by Excel computer program. RESULTS: the total costs associated with pressure ulcers and falls:Surgery Service, first semester of 2017: -Pressure ulcers $ 44,086,872 (U$ 57,557)-Falls $ 39,630,517 (U$ 51,739) -Total cost$ 83,717,389 (U$ 109,297)Medicine Service, first semester of 2017: -Pressure ulcers $ 22,654,894 (U$29,803 dollars) -Falls $ 32,023,185 (U$41,807 dollars) -Total cost $ 54,678,079 (U$71,385 dollars)Surgery Service, first semester of 2018: -Pressure ulcers $ 76,979,440 (U$100,500 dollars) -Falls $ 18,522,927 (U$24,182 dollars) -Total cost $ 95,502,367 (U$124,683 dollars)Medicine Service, first semester of 2018: -Pressure ulcers $ 14,981,255 (U$19,558 dollars) -Falls $ 55,258,625 (U$72,142dollars) -Total cost $ 70,239,880 (U$91,701 dollars) CONCLUSIONS: it was possible to collect current information on financial and clinical resources that determine the economic impact generated by adverse events in patients treated in a public healthcare center. This is why the present study made it possible to quantify and demonstrate the economic impact of two events that occurred in the clinical services of a highly complex hospital in Chile.
Subject(s)
Humans , Database Management Systems/instrumentation , Pressure Ulcer/diagnosis , Pressure Ulcer/etiology , Research Design , Software , Chile , Retrospective Studies , Risk Factors , Statistics as Topic , Health Care Costs , Cost of Illness , Risk Assessment , Pressure Ulcer/economics , Emergency Medical Services/statistics & numerical data , Patient SafetyABSTRACT
Brazilian spotted fever (BSF) is a vector-borne zoonosis caused by Rickettsia rickettsii bacteria. Dogs can be host sentinels for this bacterium. The aim of the study was to determine the presence of antibodies against Rickettsia spp. in dogs from the city of São José dos Pinhais, State of Paraná, Southern Brazil, where a human case of BSF was first reported in the state. Between February 2006 and July 2007, serum samples from 364 dogs were collected and tested at 1:64 dilutions by indirect immunofluorescence assay (IFA) against R. rickettsii and R. parkeri. All sera that reacted at least to one of Rickettsia species were tested against the six main Rickettsia species identified in Brazil: R. rickettsii, R. parkeri, R. bellii, R. rhipicephali, R. amblyommii and R. felis. Sixteen samples (4.4 percent) reacted to at least one Rickettsia species. Among positive animals, two dogs (15.5 percent) showed suggestive titers for R. bellii exposure. One sample had a homologous reaction to R. felis, a confirmed human pathogen. Although Rickettsia spp. circulation in dogs in the area studied may be considered at low prevalence, suggesting low risk of human infection, the present data demonstrate for the first time the exposure of dogs to R. bellii and R. felis in Southern Brazil.
A febre maculosa brasileira (FMB) é uma zoonose veiculada por carrapatos e causada pela bactéria Rickettsia rickettsii, podendo os cães ser hospedeiros sentinelas para essa bactéria. O objetivo do estudo foi determinar a presença de anticorpos contra Rickettsia spp. em cães de São José dos Pinhais, estado do Paraná, Sul do Brasil. Entre fevereiro de 2006 e julho de 2007, amostras séricas de 364 cães foram coletadas e testadas na diluição de 1:64 por Reação de Imunofluorescência Indireta (RIFI) contra R. rickettsii e R. parkeri. Todos os soros reagentes para pelo menos uma espécie de Rickettsia foram testados contra as seis principais espécies de Rickettsia identificadas no Brasil: R. rickettsii, R. parkeri, R. bellii, R. rhipicephali, R. amblyommii e R. felis. Dezesseis amostras (4,4 por cento) reagiram para pelo menos uma espécie de Rickettsia. Dos animais positivos, dois cães (15,5 por cento) apresentaram títulos sugestivos de exposição a R. bellii. Uma amostra apresentou reação homóloga frente à R. felis, um agente patogênico confirmado para seres humanos. Muito embora os resultados demonstrem uma baixa prevalência de Rickettsia spp. em cães, sugerindo um baixo risco de infecção humana, este estudo relatou pela primeira vez a evidência de exposição a R. bellii e R. felis em cães no Sul do Brasil.