Analyses of the effectiveness of a Brazilian pediatric home care service: a preliminary study

BMC Health Serv Res. 2019 May 22;19(1):324. doi: 10.1186/s12913-019-4148-4.

Abstract

Background: Technological advances in health care currently provide better care conditions and have increased survival rates of premature infants, along with increasing the life expectancy of chronically ill children. In this context, the home care service has emerged as an effective tool for the treatment of this group of children. Thus, this preliminary study aimed at evaluating the effectiveness of the Home Care Service (HCS) with regard to pediatric care.

Methods: A cross-sectional study was performed through a medical record analysis of a tertiary hospital in Minas Gerais/Brazil. Two groups were compared: 36 patients from the HCS (home group) and 13 patients hospitalized with an indication for home care (hospital group). To analyze the effectiveness of HCS, we evaluated the number of readmissions, infection rate, number of procedures, and optimization of beds.

Results: The hospital group presented 6.04 times more infections and was submitted to 6.43 times more procedures. The home group presented lower readmission rates; with 41.66% of children studied not being readmitted and 76.19% of those who needed readmissions did so after more than 30 days from hospital discharge. HCS optimized hospital beds and allowed, over five (5) years, the hospitalization of around 102 patients in the hospital studied.

Conclusion: In this preliminary study, HCS reduced the number of procedures and infections compared to hospitalized patients. Moreover, HCS presented lower readmission rates and optimized hospital beds, which could be considered an indication of effectiveness.

Keywords: Chronic disease; Health service effectiveness; Home care.

Publication types

  • Comparative Study

MeSH terms

  • Brazil / epidemiology
  • Child
  • Child Health Services / statistics & numerical data
  • Chronic Disease
  • Cross-Sectional Studies
  • Diagnostic Tests, Routine / statistics & numerical data
  • Female
  • Home Care Services / standards*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Infant
  • Infections / epidemiology
  • Infections / therapy*
  • Male
  • Patient Discharge / statistics & numerical data
  • Patient Readmission / statistics & numerical data