UTILIZAÇÃO DOS SETORES DE CUIDADO DE SAÚDE POR CRIANÇAS EGRESSAS DE UNIDADE DE TERAPIA INTENSIVA NEONATAL

Abstract

For children coming from the Neonatal Intensive Care Unit - NICU, post-discharge follow-up is recommended. These children will be cared for at home by their families, but between health care practices and locations used there is still a knowledge gap. In seeking to address health problems, people commonly turn to one of three health care sectors: informal, popular, and professional. Objectives To identify the sectors and health care practices used by children com ing from NICUs in the city of São Luís (MA) and to understand the relationship between the search for popular care and the sociodemographic and health conditions related to these children and their families. Method Retrospective cohort with a sample of 165 children under 48 months old living in São Luís. Data was collected at two moments: identification of all children born in 2014 and 2015; and interview. The variables collected were maternal and child, including sociodemographic, perinatal, discharge and post discharge data; and those of the health care sectors and their practices. A theoretical model was created establishing the relationship be tween socioeconomic conditions, the occurrence of morbidity at discharge and its direct or in direct impact on the search for the popular sector. Descriptive analysis was performed using Pearson's chi-square test and in the analysis of associated factors, Structural Equation Modeling was used. Results Most children had no morbidity at discharge from the NICU (67.3%), among them 46.8% used the informal sector (p = 0.016). Most non-white-skinned mothers reported using informal care practices (p = 0.030). The professional sector was used by all children under study, especially the search for a pediatrician/general practitioner (59.4%). In the informal sec tor, the use of self-medication (71.4%) was highlighted, and in the popular sector, the search for a traditional healer/faith healer (55.3%). The occurrence of morbidity at discharge recorded a significant total effect with Standardized Coefficient (PC) = 0.302 and p-value = 0.030. How ever, there was no direct effect of this variable on the search for care in the popular sector (CP = 0.278; p = 0.075). Conclusions The search for the popular and informal sectors was less frequent in children with morbidities at discharge or with illness in the post-discharge period. However, the occurrence of morbidity at discharge from the NICU is a factor that may influence the search for health care in the popular sector.