Profile of general hospitals in the Unified Health System
ABSTRACT OBJECTIVE To characterize the organization of Brazilian general hospitals that provide services to the Unified Health System using indicators that describe the main dimensions of hospital care. METHODS A 2015 cross-sectional observational study, comprising the range of general hospitals...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2020-08-01
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| Series: | Revista de Saúde Pública |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100260&tlng=en |
| _version_ | 1798021783418306560 |
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| author | Laura de Almeida Botega Mônica Viegas Andrade Gilvan Ramalho Guedes |
| author_facet | Laura de Almeida Botega Mônica Viegas Andrade Gilvan Ramalho Guedes |
| author_sort | Laura de Almeida Botega |
| collection | DOAJ |
| description | ABSTRACT OBJECTIVE To characterize the organization of Brazilian general hospitals that provide services to the Unified Health System using indicators that describe the main dimensions of hospital care. METHODS A 2015 cross-sectional observational study, comprising the range of general hospitals that serve the Unified Health System. We constructed the hospital indicators from two national administrative databases: the National Registry of Health Facilities and the Hospital Information System of the Unified Health System. The indicators include the main dimensions associated with hospital care: public-private mix, production, production factors, performance, quality, case-mix and geographic coverage. Latent class analysis of indicators with bootstrapping was used to identify hospital profiles. RESULTS We identified three profiles, with hospital size being the variable with the highest degree of belonging. Small hospitals show low occupancy rates (21.36%) and high participation of hospitalizations that could have been solved with outpatient care, besides attending only medium complexity cases. They receive few non-residents, indicating that they are mainly dedicated to the local population. Medium-sized hospitals are more similar to small-sized ones: about 100% of the visits are of medium complexity, low occupancy rate (45.81%), high rate of hospitalizations for primary care sensitive conditions (17.10%) and relative importance in the healthcare provision of non-residents (26%). Large hospitals provide high complexity care, have an average occupancy rate of 64.73% and show greater geographical coverage. CONCLUSIONS The indicators point to three hospital profiles, characterized mainly by the production scale. Small hospitals show low performance, suggesting the need to reorganize hospital care provision, especially at the municipal level. The set of proposed indicators includes the main dimensions of hospital care, providing a tool that can help to plan and continuously monitor the hospital network of the Unified Health System. |
| first_indexed | 2024-04-11T17:19:12Z |
| format | Article |
| id | doaj.art-888e6e9065f74ae99229234cd15d7c9e |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-04-11T17:19:12Z |
| publishDate | 2020-08-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-888e6e9065f74ae99229234cd15d7c9e2022-12-22T04:12:32ZengUniversidade de São PauloRevista de Saúde Pública1518-87872020-08-015410.11606/s1518-8787.2020054001982Profile of general hospitals in the Unified Health SystemLaura de Almeida Botegahttps://orcid.org/0000-0001-6030-4100Mônica Viegas Andradehttps://orcid.org/0000-0002-6821-1598Gilvan Ramalho Guedeshttps://orcid.org/0000-0001-8231-238XABSTRACT OBJECTIVE To characterize the organization of Brazilian general hospitals that provide services to the Unified Health System using indicators that describe the main dimensions of hospital care. METHODS A 2015 cross-sectional observational study, comprising the range of general hospitals that serve the Unified Health System. We constructed the hospital indicators from two national administrative databases: the National Registry of Health Facilities and the Hospital Information System of the Unified Health System. The indicators include the main dimensions associated with hospital care: public-private mix, production, production factors, performance, quality, case-mix and geographic coverage. Latent class analysis of indicators with bootstrapping was used to identify hospital profiles. RESULTS We identified three profiles, with hospital size being the variable with the highest degree of belonging. Small hospitals show low occupancy rates (21.36%) and high participation of hospitalizations that could have been solved with outpatient care, besides attending only medium complexity cases. They receive few non-residents, indicating that they are mainly dedicated to the local population. Medium-sized hospitals are more similar to small-sized ones: about 100% of the visits are of medium complexity, low occupancy rate (45.81%), high rate of hospitalizations for primary care sensitive conditions (17.10%) and relative importance in the healthcare provision of non-residents (26%). Large hospitals provide high complexity care, have an average occupancy rate of 64.73% and show greater geographical coverage. CONCLUSIONS The indicators point to three hospital profiles, characterized mainly by the production scale. Small hospitals show low performance, suggesting the need to reorganize hospital care provision, especially at the municipal level. The set of proposed indicators includes the main dimensions of hospital care, providing a tool that can help to plan and continuously monitor the hospital network of the Unified Health System.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100260&tlng=enHospitals, General, organization & administration, indicatorsHealth care, classificationHospital AdministrationBrazilian Unified Health System |
| spellingShingle | Laura de Almeida Botega Mônica Viegas Andrade Gilvan Ramalho Guedes Profile of general hospitals in the Unified Health System Revista de Saúde Pública Hospitals, General, organization & administration, indicators Health care, classification Hospital Administration Brazilian Unified Health System |
| title | Profile of general hospitals in the Unified Health System |
| title_full | Profile of general hospitals in the Unified Health System |
| title_fullStr | Profile of general hospitals in the Unified Health System |
| title_full_unstemmed | Profile of general hospitals in the Unified Health System |
| title_short | Profile of general hospitals in the Unified Health System |
| title_sort | profile of general hospitals in the unified health system |
| topic | Hospitals, General, organization & administration, indicators Health care, classification Hospital Administration Brazilian Unified Health System |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102020000100260&tlng=en |
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