Assistência fisioterapêutica 24 horas em doenças crônicas nos custos da Unidade de Terapia Intensiva nível III

Abstract

Introduction: The total cost per patient in the intensive care unit (ICU) is closely related to the severity of the disease, number of comorbidities and length of stay. Thus, the study aims to investigate the influence of the insertion of 24-hour physical therapy care (PT-24 hours) compared with 14-hour coverage (PT-14 hours) in the ICU level III in patients with mechanically ventilated chronic diseases. Methods: This is a retrospective cross-sectional study, composed of a convenience sample of patients using invasive mechanical ventilation (IMV) admitted to the ICU, from May 2020 to May 2022, in a public hospital. The following data were compiled to characterize the sample: age, gender, chronic diseases, classification of severity by diagnostics related group methodology, expected and performed hospital stay, occurrence of infectious and non-infectious incident, hospital outcome (death/non-death), IMV time and costs per patient. The variables were tested for normality by the Anderson Darling test. The Kruskal-Wallis tests followed by Pos hoc Conover and Mann Whitney were used to compare the differences between the medians. The significance level of p<0.05 was adopted. The R software (R Core Team, 4.2.1) was used to perform the analyses. Results: The sample consisted of 469 patients, PT-14 hours 267 and PT-24 hours 202 patients, with arterial hypertension being the most prevalent comorbidity in both coverage of therapeutic care, 73% and 76.7%, respectively. The severity classification was similar in both groups. The insertion of pt-24 hours in the ICU compared to the coverage of the PT-14 hours, did not present statistical difference (p<0,005), but with a reduction in the total gross cost of 23%. Conclusion: The insertion of pt-24 hours in the ICU resulted in a lower percentage of the total gross amount spent on the hospitalization of critically ill patients when compared to patients who were only assisted by the PT-14 hours.