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A saúde na Região Autónoma dos Açores: um novo percurso baseado na evidência populacional
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Abstract(s)
A Região Autónoma dos Açores apresenta-se como uma das regiões do País com maior desigualdade a nível de saúde; nomeadamente, uma população com elevada morbilidade, tal como espelhado no último Inquérito Regional de Saúde.
Aliando tal realidade ao caráter idiossincrático da Região, onde se verifica a existência de fenómenos de dupla insularidade, urge garantir a melhoria das condições de saúde da população, uma vez que a manutenção destas se apresenta como a base para a vivência dos seres humanos.
Neste sentido definiu-se como cerne do trabalho o ajustamento do financiamento das unidades do Serviço Regional de Saúde da Região Autónoma dos Açores pelo risco e pelos resultados com valor em saúde.
Para tal, caracterizou-se a saúde desta população, através da sua evidência populacional. Assim, caracterizou-se a mesma a nível da sua carga de doença (por concelhos), através de Anos de Vida ajustados pela Incapacidade (AVAI).
Considerando que é objetivo a nível mundial adequar o financiamento das unidades de saúde à noção de valor em saúde, optou-se por utilizar uma estratégia metodológica que promovesse a participação dos cidadãos nesta temática, bem como que corresponsabilizasse os Cuidados de Saúde Primários pela atividade em ambiente hospitalar.
Verificou-se que no ano de 2016, nesta Região, perderam-se 140 600 AVAI, sendo que uma proporção levada, 14,73%, se deveu a Doenças endócrinas, nutricionais e metabólicas.
Relativamente ao financiamento das Unidades de Saúde, a utilização da capitação como base do modelo de financiamento, e consequente ajuste pela carga de doença, levaria à variação positiva de até 6,75% do Orçamento do Serviço Regional de Saúde.
Considera-se assim que este trabalho apresenta resultados de impacto societal que podem, a curto-médio prazo permitir uma melhoria da saúde dos cidadãos e das cidadãs açorianas, não se podendo, de todo, afirmar somente como um trabalho académico.
The Azores is the region of Portugal showing the greatest inequality in health; namely,the population the highest morbidity, as reflected by the last Regional Health Survey. Combining this reality with the idiosyncratic character of the Region (their double insularity), it is imperative to guarantee the improvement of the health conditions of the population, taking into account that is one of the basis for human existence. As a result, the core of the thesis is the financing of the units of the Azorean Regional Health Service adjusted by the risk and by the results with health value. To this end, the health of the Azorean population was characterized through its evidence in terms of disease burden (by municipalities), through Disability-adjusted Life Years (DALY). Considering the global objective of adjusting the financing of health units to the notion of health value, it was decided to use a methodological strategy that promotes the participation of citizens, as well as to develop a co-responsibility between Primary Health Care Units and the Hospitals. It was verified that in 2016, 140,600 years of life adjusted for disability were lost in this Region. The highest percentage, 14.73%, was due to endocrine, nutritional and metabolic diseases. Regarding the financing of the health units, the use of capitation as the basis for the financing model and consequent adjustment for the disease burden, would lead to a positive variation of up to 6.75% of the Budget of the Regional Health Service. It is considered that this work presents results with societal impact that can, in the short-medium term, allow an improvement in the health levels of the Azorean citizens. By this, it is possible to claim that this study is not a mere an academic work.
The Azores is the region of Portugal showing the greatest inequality in health; namely,the population the highest morbidity, as reflected by the last Regional Health Survey. Combining this reality with the idiosyncratic character of the Region (their double insularity), it is imperative to guarantee the improvement of the health conditions of the population, taking into account that is one of the basis for human existence. As a result, the core of the thesis is the financing of the units of the Azorean Regional Health Service adjusted by the risk and by the results with health value. To this end, the health of the Azorean population was characterized through its evidence in terms of disease burden (by municipalities), through Disability-adjusted Life Years (DALY). Considering the global objective of adjusting the financing of health units to the notion of health value, it was decided to use a methodological strategy that promotes the participation of citizens, as well as to develop a co-responsibility between Primary Health Care Units and the Hospitals. It was verified that in 2016, 140,600 years of life adjusted for disability were lost in this Region. The highest percentage, 14.73%, was due to endocrine, nutritional and metabolic diseases. Regarding the financing of the health units, the use of capitation as the basis for the financing model and consequent adjustment for the disease burden, would lead to a positive variation of up to 6.75% of the Budget of the Regional Health Service. It is considered that this work presents results with societal impact that can, in the short-medium term, allow an improvement in the health levels of the Azorean citizens. By this, it is possible to claim that this study is not a mere an academic work.
Description
Keywords
Carga de doença Ajustamento pelo risco Região Autónoma dos Açores Anos de vida ajustados pela incapacidade Financiamento de sistemas de saúde