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Análise crítica à via verde do AVC a unidade de Faro do centro Hospitalar Universitário do Algarve
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Abstract(s)
O Acidente Vascular Cerebral (AVC) é uma das maiores causas de morte a nível global e a principal causa de incapacidade, sendo um grave problema de saúde pública.
Com base nestes dados, foram definidos objetivos globais a nível da gestão do AVC, com o objetivo de reduzir a taxa de mortalidade e a incapacidade inerente à patologia. Em Portugal, em 2006, foi implementada a Via Verde do AVC (VV-AVC), que consiste na otimização de processos internos com o objetivo de reduzir o tempo de espera para o tratamento.
De modo a aferir a efetividade desta medida, neste estudo foi feita uma análise de custo-efetividade da VV-AVC da Unidade de Faro do Centro Hospitalar Universitário do Algarve, pertencendo ao Serviço Nacional de Saúde (SNS).
Para tal, foi analisada a base de dados dos 448 doentes que sofreram um AVC isquémico e que foram submetidos a fibrinólise entre 2006 e 2018, em que foram recolhidas informações como a idade, o género, a distância a que estavam do Hospital e o tempo que demoraram a chegar, a severidade inicial do AVC, a duração do internamento e a Escala Modificada de Rankin
Apurou-se que a distância não apresenta ser significativa para a incapacidade resultante após o AVC, uma vez que o tempo total entre o início dos sintomas e o início da fibrinólise é muito semelhante entre os diferentes grupos da Escala Modificada de Rankin, sendo que em média representa um intervalo de 163,3 minutos, em que o tempo porta-agulha médio é 76 minutos, acima do que se pode observar em alguns estudos.
Em suma, pode-se concluir que há espaço para melhorar nos processos internos, com o objetivo de reduzir o intervalo de tempo e assim a incapacidade inerente à doença.
Stroke is one of the biggest causes of death globally and the leading cause of disability, making it a serious public health problem. Based on this data, global objectives have been set for stroke management, with the aim of reducing the mortality rate and the disability inherent in the condition. In Portugal, the Via Verde do AVC (VV-AVC) was implemented in 2006, which consists of optimizing internal processes with the aim of reducing waiting times for treatment. In order to assess the effectiveness of this measure, this study carried out a cost-effectiveness analysis of the VV-AVC at the Faro Unit of the Centro Hospitalar Universitário do Algarve, which belongs to the National Health Service (SNS). To do this, the database of 448 patients who suffered an ischemic stroke and underwent fibrinolysis between 2006 and 2018 was analyzed, collecting information such as age, gender, distance from the hospital and time taken to arrive, initial stroke severity, length of hospital stay and the modified Rankin scale. It was found that distance is not significant for the resulting disability after stroke, since the total time between the onset of symptoms and the start of fibrinolysis is very similar between the different groups on the Modified Rankin Scale, and on average represents an interval of 163.3 minutes, where the average door-to-needle time is 76 minutes, higher than can be seen in some studies. In short, it can be concluded that there is room for improvement in internal processes, with the aim of reducing the time interval and thus the disability inherent in the disease.
Stroke is one of the biggest causes of death globally and the leading cause of disability, making it a serious public health problem. Based on this data, global objectives have been set for stroke management, with the aim of reducing the mortality rate and the disability inherent in the condition. In Portugal, the Via Verde do AVC (VV-AVC) was implemented in 2006, which consists of optimizing internal processes with the aim of reducing waiting times for treatment. In order to assess the effectiveness of this measure, this study carried out a cost-effectiveness analysis of the VV-AVC at the Faro Unit of the Centro Hospitalar Universitário do Algarve, which belongs to the National Health Service (SNS). To do this, the database of 448 patients who suffered an ischemic stroke and underwent fibrinolysis between 2006 and 2018 was analyzed, collecting information such as age, gender, distance from the hospital and time taken to arrive, initial stroke severity, length of hospital stay and the modified Rankin scale. It was found that distance is not significant for the resulting disability after stroke, since the total time between the onset of symptoms and the start of fibrinolysis is very similar between the different groups on the Modified Rankin Scale, and on average represents an interval of 163.3 minutes, where the average door-to-needle time is 76 minutes, higher than can be seen in some studies. In short, it can be concluded that there is room for improvement in internal processes, with the aim of reducing the time interval and thus the disability inherent in the disease.
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Keywords
AVC Análise custo-efetividade Escala de rankin modificada Daly Via verde Tempo porta-agulha