28/07/2018 - 14:30 - 16:00
CO20k - Avaliação de Serviços de Saúde |
28786 - DIFFERENCES BETWEEN LOW-LOW AND HIGH- HIGH RISK AREAS OF HOSPITALIZATIONS DUE TO LOW IMPACT FALLS. THE RELEVANCE OF PROXIMITY CARE
ANA CATARINA BESSA - 1 I3S – INSTITUTO DE INVESTIGAÇÃO E INOVAÇÃO EM SAÚDE, UNIVERSIDADE DO PORTO, PORTUGAL 2 INEB – INSTITUTO DE ENGENHARIA BIOMÉDICA, UNIVERSIDADE DO PORTO, PORTUGAL 3 FACULDADE DE FARMÁCIA DA UNIVERSIDADE DO PORTO, SANDRA MARIA ALVES - 1 I3S – INSTITUTO DE INVESTIGAÇÃO E INOVAÇÃO EM SAÚDE, UNIVERSIDADE DO PORTO, PORTUGAL 2 INEB – INSTITUTO DE ENGENHARIA BIOMÉDICA, UNIVERSIDADE DO PORTO, PORTUGALESCOLA SUPERIOR DE SAÚDE, POLITÉCNICO DO PORTO, MARIA DE FÁTIMA PINA - 1 I3S – INSTITUTO DE INVESTIGAÇÃO E INOVAÇÃO EM SAÚDE, UNIVERSIDADE DO PORTO, PORTUGAL 2 INEB – INSTITUTO DE ENGENHARIA BIOMÉDICA, UNIVERSIDADE DO PORTO, PORTUGAL5 DEPARTAMENTO DE EPIDEMIOLOGIA CLÍNICA, MEDICINA PREDITIVA E SAÚDE PÚBLICA, FACULDADE DE MED
Apresentação/Introdução
Low impact falls may result from falling from a chair or tripping on a mat. The continual increase of elderly population poses as a problem to healthcare systems as there will be more individuals needing assistance after suffering a fall. Despite extensive research and preventive efforts, accidental falls continues to be a leading cause of severe injury requiring acute care or causing death.
Objetivos
The aim was to identify spatial pattern of hospitalizations due to low impact falls, in individuals over 65 years old in Continental Portugal (2000, 2007 and 2013) and compare different hospitalization risk areas regarding indirect health indicators.
Metodologia
Hospitalizations caused by low impact falls (ICD9-CM) were retrieved from the National Hospital Discharge Register, population data and indirect health indicators from Statistics Portugal. Empirical Bayesian incidence rates (AEB) by municipality (2000, 2007,2013) 1000 inhabitants (direct-method, Portuguese Census 2011), Moran’s I and Local Moran’s I were calculated for both genders. The indicators portrayed health status and available infrastructures and were compared between high-high and low-low areas using Mann-Whitney. For each municipality, was calculated a mean value by indicator (2000- 2006) to compared across different risk areas in 2007 and similar to 2013 (2007- 2012).
Resultados
The annual crude rates were similar in the three years assessed; both genders: 10 per 1000 inhabitants in the three years, female: 11, 12, and 12 per 1000 inhabitants in 2000, 2007 and 2013 (respectively) and male: 7 in 2000, 7 in 2007 and 8 in 2013 (1000 habitants). A similar overall spatial pattern was observed in both genders: clusters of high incidence in the north and low incidence in the south. Over time a marked northeast to southwest pattern was accentuated.
Statistical differences were observed the indicators: number of pharmacies, number of health centers (higher values in low-low risk areas), number of hospitalizations, number of nurses (higher values in high-high areas).
Conclusões/Considerações
Marked spatial patterns in hospitalization due to low energy falls were identified in both genders. Results suggest that areas in low-low risk present higher values in indirect health indicators related to primary care, namely pharmacies and health centers that by being more close to the population may be responsible for preventive measures, lecturing population towards healthier habits leading to less accidental falls episodes.
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