Análise do modelo atual de assitência ao diabetes no SUS: uma experiência no Hospital Universitário.

Abstract

Introduction: Diabetes Mellitus is a chronic disease, considered one of the great global epidemic the 21stcentury and a public health problem. It is estimated that 8.5% of the Brazilian population hás the disease. It represents 5.2% of the causes of death in the country, na important risk factor for cardiovascular diseases that are responsible for 31.3% of deaths. It is a health condition considered sensitive to Primary Care. A good management of this problem in Primary Care prevents hospitalizations and deaths from chronic complications of the disease. Since the 1990s, the government hás been trying to implementan articulated and integrated model, in linewith Health Unic System (SUS in Portuguese) principles and better cost-effectiveness, surpas sing the biomedical model that is based on professional incorporation centered on medical specialties and hospital structure. Objectives: To analyze the current model of care provided to diabetics in the SUS, from the perspective of a Tertiary Hospital, through the assessment of the clinical profile of patients followed and the applicability of there ferral protocol of the Ministry of Health. Methods: A quantitative study was accomplished, crosssectional, analytical, observational, non-interventional, involving 375 patients with Diabetes Mellitus 2 from the Endocrinology Service ofthe Hospital Universitário Presidente Dutra in São Luís-MA, realized through the collection of clinical data recorded in electronic medical records. Results: most were women (64.8%), with average age of 62.5 years. Regarding clinical data, 58.7% had more than 10 years of disease, 45.1% used insulin, 49.9% used two classes of oral drug, 50.4% did not have the disease compensated. Regarding comorbidities, 62.4% had Systemic Arterial Hypertension and dylipidemia concomitantly. Diabetic nephropathy was the most common chronic complication, in 25.9% of patients, followed by diabetic retinopathy (19.2%), Coronary disease 7.2% and Stroke 4.8%. Only 21.9% had an indication for referral to a specialized service. Conclusions: The study concluded that many patients followed in tertiary care could be followed in primary care. What reinforces the hypothes is that the care model is still the biomedical model that prioritizes individual care with a focus on the specialty, engendering greater costs for the SUS.