Hospital-acquired conditions and length of stay in the pregnancy and puerperal cycle

• Published in: Revista de saúde pública Vol. 53; p. 64
• Main Authors: Silva, Thales Philipe Rodrigues da, Carmo, Ariene Silva do, Novaes, Taiane Gonçalves, Mendes, Larissa Loures, Moreira, Alexandra Dias, Pessoa, Milene Cristine, Cosenza, Luna, Pereira, Juliana Fantini Chaves, Matozinhos, Fernanda Penido
• Format: Journal Article
• Language: English
• Published: Brazil Faculdade de Saúde Pública da Universidade de São Paulo 01.01.2019; Universidade de São Paulo
• Subjects: Brazil; Cesarean Section; Comorbidity; Cross-Sectional Studies; Delivery, Obstetric - statistics & numerical data; Female; Health Policy & Services; Hospital Costs; Hospitalization; Hospitalization - statistics & numerical data; Humans; Iatrogenic Disease; Length of Stay - statistics & numerical data; Length of Stay, economics; Original; Patient Discharge - statistics & numerical data; Postpartum Period; Pregnancy; Pregnant Women; Puerperal Disorders; Brazil; Hospital Costs; Custos Hospitalares; Length of Stay, economics; Puerperal Disorders; Pregnant Women; Hospitalização; Transtornos Puerperais; Tempo de Internação, economia; Hospitalization; Gestantes
• ISSN: 0034-8910; 1518-8787; 1518-8787
• DOI: 10.11606/s1518-8787.2019053000688

To analyze the impact of the Hospital-Acquired Conditions (HAC) in women in the puerperal and pregnancy cycle during length of stay. This cross-sectional study was conducted with 113,456 women, between July 2012 and July 2017, in Brazil's national hospitals of the supplementary healthcare networks and philanthropists accredited to the Unified Health System (SUS). Data on hospital discharges were collected using the Diagnosis-Related Groups (DRG Brasil®) system. All DRGs of the major diagnostic category 14 (MDC14), including pregnancy, childbirth and puerperium, were included. The impact of HAC on length of stay was estimated by Student's t-test, and the effect size by Cohen's d, which allows to assess clinical relevance. The most prevalent diagnostic categories related to MDC14 were vaginal and cesarean deliveries without complicating diagnoses, both at institutions accredited to SUS and those for supplementary health care. The prevalence of HAC was 3.8% in supplementary health and 2.5% in SUS. Hospitals providing services to supplementary health care providers had a longer length of stay considering HAC for patients classified as DRG: cesarean section with complications or comorbidities at admission (p < 0.001; Cohen's d = 0.74), cesarean section without complications or comorbidities at admission (p < 0.001, Cohen's d = 0.31), postpartum and post abortion without listed procedure (p < 0.001, Cohen's d = 1.05), and other antepartum diagnoses with medical complications (p < 0.001; Cohen's d = 0.77). This study showed that the prevalence of HAC was low both in the institutions accredited to attend by SUS and in those of supplementary health; however, its presence contributes to increasing the length of stay in cases of cesarean sections without complications or comorbidities in supplementary health institutions.