Fatores associados à gestão de permanência dos usuários da cardiologia na atenção ambulatorial especializada do Sistema Único de Saúdeestudo observacional em um ambulatório municipal

Resumo

The study examined factors influencing the length of stay of users in secondary‑level cardiology care at a public specialty outpatient clinic of the Brazilian Unified Health System (SUS) in Santos, São Paulo, and sought to understand to what extent specialized care can discharge patients and return their comprehensive care to primary care or refer them, when necessary, to tertiary care. Its objective was to identify clinical, administrative, and system‑level factors associated with a higher probability of discharge from cardiology, providing evidence to optimize patient flow, reduce unnecessary follow‑up visits, and improve the use of specialized capacity. This was an observational, applied, quantitative, descriptive study based on secondary data from the unit’s electronic information systems, encompassing cardiology consultations, use of primary care, other medical specialties, diagnostic tests, and ICD‑10‑coded diagnoses. The unit of analysis was the patient, consolidating the care trajectory in a single database and using descriptive statistics and binary logistic regression to investigate factors associated with the outcome of discharge. Results characterized the sociodemographic and clinical profile of the population, the discharge rate, and the number of follow‑up visits required, and demonstrated the influence of variables such as age, sex, most frequent diagnoses, primary care use, absenteeism, and participation of other specialties on the probability of discharge from cardiology. Some subgroups presented a higher likelihood of discharge with fewer consultations, suggesting potential for more intensive management in primary care, whereas other profiles required prolonged follow‑up or referral to higher‑complexity levels. The study concluded that there are opportunities to improve the duration and trajectory of users’ stay in cardiology care through strategies for managing care flow, strengthening coordination with primary care, expanding the use of telehealth, and actively managing user absenteeism. These proposals have practical implications for managers and care teams, reinforcing the importance of integrating information systems, regulatory processes, and matrix support to reduce waiting lists, enhance the use of specialized consultations, and align outpatient cardiology care with recent guidelines of the National Specialized Care Policy.

Ficha do documento

Tipo

Dissertação

Ano

2026

Instituição

Fundação Getulio Vargas

Fonte

Repositório da FGV

Idioma

Português

Acesso

Acesso aberto

Identificador

oai:repositorio.fgv.br:10438/40212

Temas

Saúde

Palavras-chave

Assistência ambulatorialListas de esperaAcesso efetivo aos serviços de saúdeRegulação e fiscalização em saúdeResultado do tratamentoOutpatient careWaiting listsEffective access to health servicesHealth regulation and oversightTreatment outcomeAdministração de empresasCuidados médicos ambulatoriaisHospitais - Listas de esperaAcesso aos serviços de saúdeSaúde pública - AdministraçãoODS 3: Saúde e bem-estar