Cuidados intermediários e hospitais comunitários: uma revisão integrativa

Abstract

Epidemiological changes resulting from population aging have motivated a series of transformations in global health systems. In this sense, from the 1990s onwards, the England begins to discuss the adoption of a health care model called Intermediate Care, which promoted the development of intermediate care services in several countries. The objective of this work is to gather and analyze the national literature and produced about Intermediate Care, with emphasis on the services of Community Hospitals. Therefore, as a methodology, an integrative review was carried out. of the literature from the creation of 14 search keys that combined, with the operator boolean AND, six descriptors and keywords: “Intermediate Care”, “Community Hospitals”, “Intermediate Care Facilities”, “Long-Term Care”, “Hospitals Chronic Disease” and “Rehabilitation Services”. The descriptors were combined in Portuguese, English, Spanish and Italian by using the Boolean OR operator. The search was carried out in the bases VHL Regional Portal, Pubmed and BDTD. A filter was used in the databases to obtain “available documents”, in line with the Budapest Open agreement Access Initiative; and were not limited to year of publication or language. of documents included for qualitative synthesis, the following information was extracted: author, year of publication, country, language, study design, document format, objective and main results. In addition, a qualitative synthesis of the documents was carried out with a view to contrasting results and authors' arguments to compose the discussion of this work. Results: On the three bases, the use of search keys generated 72,354 documents. With the application of the filter "available documents", this number was reduced to 34,027, for which the reading the titles. After reading the titles, 203 were included for the next step. documents, in which the abstracts were read, including 134, of which 73 were excluded because they are duplicities; resulting in 61 documents included for reading in full. After reading in full, 30 documents were included for qualitative synthesis and composition of this review. 17 documents were from the UK; 6, from Norway; 4, from Spain; 1, from Denmark; 1 Australian and 1 Italian. The predominant language was English (n=27), with 2 in Spanish and 1 in Norwegian. In relation to the design of study, there was a good distribution: 2 case studies; 5 sectional; 4 clinical trials randomized; 5 qualitative studies; 5 cohorts; 2 narrative reviews; 1 clinical trial almost experimental; in addition to 2 research protocols and 4 comments. Most documents was published in full original article format (n=22), but 8 were reports brief. Conclusions: There are still gaps in the literature on intermediate and doubts among governments about how best to provide these services. The results of researches help decision makers in the implementation of public policies of reorganization of health services, however, the knowledge gaps that need to be filled. It is encouraged that more studies are carried out on the subject with a view to provide a better theoretical and technical apparatus for decision-making in health.