Binsfeld Luciane, Gomes Maria Auxiliadora de Souza Mendes, Kuschnir Rosana
Instituto Nacional de Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2022 Feb 11;38(2):e00109521. doi: 10.1590/0102-311X00109521. eCollection 2022.
This study aimed to analyze the frequency of cases, regional distribution, and analysis of the profile of healthcare establishments in which births occurred with congenital malformation that underwent immediate surgery in the state of Rio de Janeiro, Brazil. This is a descriptive study with a quantitative approach drawing on live birth databases and the national registry of healthcare establishments. The data reveal major dispersion of births with congenital malformations, in which the great majority of health units reported less than one such birth per year. These units also lack the infrastructure with potential capacity for neonatal surgical care to be performed in the same service as the birth. The persistence of this configuration of dispersion of births and structuring of healthcare services results in missed opportunities both in quality and safety and does not contribute to achieving the minimum volume of procedures per year for specialists, for empowering the results in neonatal surgical care, such as economy of scale and timely access. By analyzing and classifying units using volume of care and potential installed capacity as criteria, we identified paths for definition of referral units and organization of networks of care.
本研究旨在分析巴西里约热内卢州发生先天性畸形且接受了即刻手术的出生病例的频率、区域分布，并分析分娩所在医疗机构的情况。这是一项采用定量方法的描述性研究，利用活产数据库和国家医疗机构登记册。数据显示，先天性畸形出生病例分布极为分散，绝大多数医疗单位报告每年此类出生病例少于1例。这些单位还缺乏在与分娩相同的服务中进行新生儿外科护理的潜在能力的基础设施。这种出生分散和医疗服务结构配置的持续存在，导致在质量和安全方面错失机会，并且无助于实现专家每年的最低手术量，不利于提高新生儿外科护理的效果，如规模经济和及时获得护理。通过以护理量和潜在装机容量为标准对单位进行分析和分类，我们确定了确定转诊单位和组织护理网络的途径。
