Strategic analysis of malformations congenital care: proposal of approach and development of care pathways

Binsfeld, Luciane; Gomes, Maria Auxiliadora de Souza Mendes; Kuschnir, Rosana

doi:10.1590/1413-81232023284.07802022EN

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ARTICLE • Ciênc. saúde coletiva 28 (4) • Apr 2023 • https://doi.org/10.1590/1413-81232023284.07802022EN copy

Strategic analysis of malformations congenital care: proposal of approach and development of care pathways

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This paper aims at presenting a proposal for grouping cases for the organization of health services and care pathways. This is an exploratory study in the field of health services planning and management, which used, as its methodology, documentary and bibliographic research as well as interviews with specialists by using nominal group technique. From the strategic analysis, four groups were identified: smaller CM; CM with late surgical approach; CM with immediate surgical approach; and CM incompatible with life. The proposition started from the articulation of clinical, epidemiological and health planning knowledge to assist in the management and organization of congenital malformations care. The strategic analysis proved to be adequate and allowed us to identify case groups that demand a homogeneous set of care strategies and care in health services with a similar profile. This proposal can also contribute to regional planning and management of care for other complex health problems and conditions, which demand the articulation of specialized services and high technological density.

Key words:
Congenital malformations; Health planning; Health management; National health networks; Maternal child health services

Primary characteristic of care	Keywords regarding pathology, technology and care
Primary characteristic of care	Is the MC classified as major or minor?	Is the Pathology compa tible with life?	Does the diagnosis in prenatal alter the manage ment of pregnancy?	Is there any demand of neonatal surgery?	Is the surgical interven tion immediate 24/48hs)?	What is the main surgical speciali zation involved?	Is there any interference on the prognosis due to the Newborn transpor tation?	Is the outpatient follow-up specialized?
MC which demands neonatal and outpatient approach	Minor	Yes	No	No	No	Not applied	No	No
MC which demands neonatal and pediatrics surgical care	Major	Yes	Yes	Yes	No	Pediatric, plastic and orthopedic surgery	No	Yes
MC which demands early neonatal surgical care	Major	Yes	Yes	Yes	Yes	Pediatric and cardiac surgery and neuros urgery	Yes	Yes
MC which demands pre-natal and neonatal approach	Major	No	Yes	No	No	Not applied	Not applied	Not applied

Classification	Groups of congenital malformations	Examples of pathologies that are part of the group
Minor	Group 1 - Minor congenital malformations
Minor	SA 1.1 Neonatal and pediatric approach	Talipes calcaneus; dysmorphic ears
Major	Group 2 - Congenital malformations of late surgical approach
	SA 2.1 Pediatric surgical approach	Palate fissure; ambiguous genitalia
	SA 2.2 Ortopedic surgical approach	Congenital hip dislocation; Congenital club food
	Group 3 - Congenital malformations of immediate surgical approach
	SA 3.1 Pediatric surgical approach	Gastroschisis; congenital diaphragmatic hernia
	SA 3.2 Neurosurgery approach	Spina Bifida; mielomeningocele
	SA 3.3 Cardiac surgical approach	Aorta coactation; pulmonary atresia
	Group 4 - Congenital malformations incompatible with life
	SA 4.1 Neonatal and obstetric approach	Anencephaly; renal agenesis

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva