緩和ケアと医学

抽象的な

Hospital Admissions of Cancer Patients in Brazil: Analysis of Palliative Care Needs

Cledy Eliana dos Santos, José Manue, Peixoto Caldas, José Américo Serafim3, Newton Barros and Altamiro da Costa Pereira5

Background: Cancer figures among the leading causes of morbidity and mortality in Brazil, with approximately 576,000 new cases and around 200,000 cancer-related deaths in 2013. According to the Brazilian National Oncological Policy, cancer control must include health promotion, prevention, diagnosis, treatment, rehabilitation, and palliative care, following the Brazilian Health System (SUS) guiding principles of Universality, Equity, and Integrality of health care. Aims: 1) Outline the hospital admissions of patients for the treatment of clinical cancer intercurrences in the Brazilian Health System (SUS) between 2008-2013; 2) Estimate the number of cancer patients with palliative care needs. Methods: Quantitative methods were employed, through the analysis of descriptive, exploratory, retrospective, and observational studies of hospitalized cancer patients. Data was collected from the Hospital Information System of Brazilian Health System (SIH/SUS) in the database of the Health Information Department (DATASUS). Results: Between 2008 and 2013, there were almost 4 million hospitalizations (3,701,409) of patients with cancer in Brazil. Of all the hospital admissions of cancer patients, 978,322 (26.4%) were related to clinical intercurrences (complications) of the disease and/or for treatment. In the same period, approximately 7 million deaths were reported to the Brazilian Mortality Information System (SIM), 15.9% (1,091,837) of cancer. The average rate of hospital mortality of clinical cancer intercurrences was three times (21.4%) higher than the mortality of patients admitted for treatment of clinical cancer in general (7.7%). The hospital length of stay (LOS) of general cancer patients was 5.7 days against 7.9 days of clinical cancer intercurrence patients. It was verified that approximately 90% of those admissions registered in the procedure "Treatment of Clinical Intercurrences of Cancer Patient” in Brazil were related to palliative care of terminally ill patients. Conclusion: The analysis of the morbidity and mortality profile of cancer patients suggests that palliative care services should be considered as criteria for the treatment of clinical cancer intercurrences. Further study of the hospital procedure “Treatment of clinical complications of cancer patient” should be considered as a parameter for scaling palliative care services in Brazil.