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一项控制重度哮喘的计划对巴西统一卫生系统资源使用的影响。

Impact that a program to control severe asthma has on the use of Unified Health System resources in Brazil.

作者信息

Ponte Eduardo, Franco Rosana Abreu, Souza-Machado Adelmir, Souza-Machado Carolina, Cruz Alvaro Augusto

机构信息

First Referral Outpatient Clinic, ProAR, Bahia State Asthma and Allergic Rhinitis Control Program, Salvador, BA, Brazil.

出版信息

J Bras Pneumol. 2007 Jan-Feb;33(1):15-9. doi: 10.1590/s1806-37132007000100006.

Abstract

OBJECTIVE

To quantify the use of health care resources among patients enrolled in the Bahia State Asthma and Allergic Rhinitis Control Program.

METHODS

As of January of 2006, 1405 patients had enrolled in the program, which is carried out in four referral centers in the city of Salvador. These patients formed the basis of this retrospective/prospective, observational cohort study. The preliminary analysis involved 269 consecutive patients, all above the age of 12 and diagnosed with severe asthma. After being seen by pulmonologists, nurses, pharmacologists and psychologists, the patients received inhaled asthma medications. Based on patient interviews and charts, the year preceding enrollment in the program was compared with the first year enrolled in the program in terms of the following quantifiable parameters: hospital admissions; emergency room visits; courses of oral corticosteroids; and days of school/work missed due to asthma attacks.

RESULTS

In this sample of patients with severe asthma, enrollment in the program resulted in significant reductions in the number of emergency room visits and hospital admissions (of 85% and 90%, respectively). There were also reductions in the number of school/work days missed due to asthma attacks and in the number of courses of oral corticosteroids (of 86% and 67%, respectively).

CONCLUSION

A program designed to control severe asthma in referral outpatient clinics and including pharmacological services at no charge can lead to a pronounced reduction in the demand for Unified Health Care System resources.

摘要

目的

量化巴伊亚州哮喘和变应性鼻炎控制项目登记患者的医疗资源使用情况。

方法

截至2006年1月,1405名患者登记参加了该项目,该项目在萨尔瓦多市的四个转诊中心开展。这些患者构成了这项回顾性/前瞻性观察队列研究的基础。初步分析涉及269例连续患者,均为12岁以上且被诊断为重度哮喘。在接受肺科医生、护士、药理学家和心理学家诊治后,患者接受了吸入性哮喘药物治疗。根据患者访谈和病历,将项目登记前一年与登记第一年在以下可量化参数方面进行比较:住院次数;急诊就诊次数;口服糖皮质激素疗程;以及因哮喘发作而错过的上学/工作日天数。

结果

在这个重度哮喘患者样本中,参加该项目导致急诊就诊次数和住院次数显著减少(分别减少85%和90%)。因哮喘发作而错过的上学/工作日天数以及口服糖皮质激素疗程数也有所减少(分别减少86%和67%)。

结论

一个旨在控制转诊门诊重度哮喘且免费提供药理服务的项目可显著减少对统一医疗保健系统资源的需求。

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