Perfil dos pacientes com permanência maior que 24 horas atendidos nas Unidades de Pronto Atendimento (UPAs) da região Metropolitana I do Estado do Rio de Janeiro.

Abstract

According to the guidelines of the Brazilian Ministry of Health, Emergency Care Units (UPAs) are responsible for keeping patients under observation for a maximum of 24 hours, for diagnostic clarification and/or clinical stabilization. This study aims to analyse the demographic and morbidity profile of patients who remained for more than 24 hours in State UPAs located in Metropolitan Region I. This is a descriptive study based on the analysis of patient care data from July 2023 to June 2024. The selected UPAs are managed by the Rio de Janeiro State Health Foundation (Fundação Saúde do Rio de Janeiro). The collected data referred to the total number of patients with a length of stay exceeding 24 hours, including variables such as race/ethnicity, age, sex, length of stay in prehospital unit, outcome and morbidity, based on the International Classification of Diseases – ICD-10. The average length of stay was also calculated and analysed by unit, disease group, age group, and type of discharge. The percentage of patients who remained in the UPAs for more than 24 hours represented 1,34% of all visits, totalling approximately 30,000 patients. The average length of stay (LOS) among these patients was 5.2 days. Regarding sex distribution, females were predominant, accounting for 53.1% of cases, with a middle age of 47.1 years. Among the types of discharge – discharge, death, and transfer – cases of discharge due to patient elopement accounted for 45% of all outcomes. For patients whose outcome was death, the middle LOS was 5.3 days and the average age was 74 years. The most prevalent ICD-10 chapters were respiratory diseases (24.44%), circulatory system diseases (19.03%), infectious and parasitic diseases (11.55%), factors influencing health status and contact with health services (9.05%), genitourinary system diseases (8.19%), and musculoskeletal system and connective tissue diseases (5.52%). Disparities among the UPAs were identified in the analysed data. One of the main limitations of the study was related to issues in the information system, during the transfer of data to the system deficiencies within the system itself.