Research notes by José Serafim
It has been a difficult task to define the number of patients in need of palliative care, the nec... more It has been a difficult task to define the number of patients in need of palliative care, the necessary resources and the specific criteria to structure and adapt palliative care services in Brazil. Until now the quantification of palliative care needs in our country has been estimated in an isolated way and based on international experiences. However, there are doubts about the applicability of these parameters considering the population and territorial dimensions, as well as the regional diversities. The analysis of the population morbidity and mortality profiles is necessary to the establishment of possible parameters to be employed for the assistance in palliative care, such as hospital admissions for the treatment of clinical intercurrences of cancer patients. Aims: To develop estimates of the current situation, the coverage and the need for palliative care services. Identify the number of hospitals that admitted potential patients with palliative care needs and the number of hospital beds used for the hospitalizations. Methods: Retrospective and observation analysis of the hospital admission registers of cancer patients were performed to verify the number of cancer patients in need of palliative care and the number of clinic hospital beds used yearly to admit these patients. Data on hospital admission of cancer patients, like average length of stay and hospital mortality were used. Results: Between 2008 and 2016, were registered in the Hospital Information System of SUS (SIH-SUS) 1,7 million hospitalizations for treatment of clinical intercurrence of cancer patient. These admissions were identified on 3,374 different health units around the country. An average of 91% of all hospitalizations for treatment of clinical intercurrence of cancer patient were registered in 380 hospitals Conclusions: To improve the quality of life, relieve physical suffering, cater for the psychological, spiritual and social needs of people with severe and advanced diseases, as well as to provide support to families and caregivers, it is indispensable to consider the existing models of health care. The inclusion or expansion of palliative attention meets the size, nature and severity of the needs of cancer patients.
Papers by José Serafim
methaodos.revista de ciencias sociales, 2017
espanolDefinir el numero de pacientes que necesitan cuidados paliativos, los recursos necesarios ... more espanolDefinir el numero de pacientes que necesitan cuidados paliativos, los recursos necesarios y los criterios especificos para estructurar y adaptar los servicios de cuidados paliativos en Brasil ha sido una tarea dificil. Hasta el momento, la cuantificacion de las necesidades de cuidados paliativos en nuestro pais ha sido estimada de un modo aislado y se ha basado en experiencias internacionales. Sin embargo, hay dudas sobre la aplicabilidad de esos parametros considerando la poblacion y las dimensiones territoriales, tan bien como las diversidades regionales. El analisis de los perfiles de morbilidad y mortalidad de la poblacion es necesario para el establecimiento de los posibles parametros para ser empleados en la asistencia a cuidados paliativos, como las admisiones hospitalarias para el tratamiento de las patologias clinicas asociadas a los pacientes de cancer. Objetivos: Desarrollar una estimacion de la situacion, la cobertura y las necesidades actuales de servicios de cui...
Revista da Associação Médica Brasileira, 2019
SUMMARY OBJECTIVE: To estimate the human resources and services needed to meet the demand of the ... more SUMMARY OBJECTIVE: To estimate the human resources and services needed to meet the demand of the Brazilian population who would benefit from palliative care, based on the population growth projection for 2040. METHODS: Population and mortality estimates and projections were obtained from the Brazilian Institute of Geography and Statistics. Service needs were estimated based on literature data. RESULTS: The expected increase in the Brazilian population for 2000-2040 is 31.5%. The minimum estimate of patients with palliative care needs was 662,065 in 2000 and 1,166,279 in 2040. The staff required for each hundred thousand inhabitants would increase from 1,734 to 2,282, the number of doctors needed would increase from 4,470 to 6,274, and the number of nurses from 8,586 to 11,294, for the same period. CONCLUSION: The definition of a national strategy predicting the increasing palliative care needs of the population is necessary. The expansion of the support network for chronic and non-t...
International Archives of Medicine, 2017
Background: Chronic non-communicable diseases (CNCD) constitute a health problem of growing magni... more Background: Chronic non-communicable diseases (CNCD) constitute a health problem of growing magnitude in Brazil, leading concerns, to the Ministry of Health (MOH), about the care of persons with chronic conditions (due to advanced diseases), multiple harms to health, convalescents and in need of long-term care, requiring continuous assistance, physical and functional rehabilitation. However, few data exist on the size of the population potentially in need of palliative care in Brazil. Aim: this study is to estimate the size of the Brazilian population that could benefit from palliative care across 26 federated states and the Federal District. Design: this is a cross-sectional study, using national death certificate and hospital admission data. Brazilian death registration and hospital admission data from 1st of January to 31st of December 2014 were analyzed and compared with estimation methods of Rosenwax and Murtagh. Setting/participants: all adults (≥ 15 years old) who died in the...
Journal of Palliative Care & Medicine, 2016
Background: Cancer figures among the leading causes of morbidity and mortality in Brazil, with ap... more 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.
methaodos revista de ciencias sociales
It has been a difficult task to define the number of patients in need of palliative care, the nec... more It has been a difficult task to define the number of patients in need of palliative care, the necessary resources and the specific criteria to structure and adapt palliative care services in Brazil. Until now the quantification of palliative care needs in our country has been estimated in an isolated way and based on international experiences. However, there are doubts about the applicability of these parameters considering the population and territorial dimensions, as well as the regional diversities. The analysis of the population morbidity and mortality profiles is necessary to the establishment of possible parameters to be employed for the assistance in palliative care, such as hospital admissions for the treatment of clinical intercurrences of cancer patients. Aims: To develop estimates of the current situation, the coverage and the need for palliative care services. Identify the number of hospitals that admitted potential patients with palliative care needs and the number of hospital beds used for the hospitalizations. Methods: Retrospective and observation analysis of the hospital admission registers of cancer patients were performed to verify the number of cancer patients in need of palliative care and the number of clinic hospital beds used yearly to admit these patients. Data on hospital admission of cancer patients, like average length of stay and hospital mortality were used. Results: Between 2008 and 2016, were registered in the Hospital Information System of SUS (SIH-SUS) 1,7 million hospitalizations for treatment of clinical intercurrence of cancer patient. These admissions were identified on 3,374 different health units around the country. An average of 91% of all hospitalizations for treatment of clinical intercurrence of cancer patient were registered in 380 hospitals Conclusions: To improve the quality of life, relieve physical suffering, cater for the psychological, spiritual and social needs of people with severe and advanced diseases, as well as to provide support to families and caregivers, it is indispensable to consider the existing models of health care. The inclusion or expansion of palliative attention meets the size, nature and severity of the needs of cancer patients.
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Research notes by José Serafim
Papers by José Serafim