{"id":14178,"date":"2019-08-28T16:17:40","date_gmt":"2019-08-28T16:17:40","guid":{"rendered":"https:\/\/staging.awgp.pt\/testes\/?page_id=14178"},"modified":"2024-04-05T15:34:47","modified_gmt":"2024-04-05T15:34:47","slug":"pbm-implementacao-nacional","status":"publish","type":"page","link":"https:\/\/staging.awgp.pt\/testes\/pbm-implementacao-nacional\/","title":{"rendered":"PBM em Portugal &#8211; Avalia\u00e7\u00e3o do Impacto"},"content":{"rendered":"<style type=\"text\/css\"><\/style>\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"14178\" class=\"elementor elementor-14178\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9f82050 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9f82050\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9fa41a4\" data-id=\"9fa41a4\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7889b8f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"7889b8f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3d6651b elementor-widget elementor-widget-spacer\" data-id=\"3d6651b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-acd209d elementor-widget elementor-widget-heading\" data-id=\"acd209d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">PBM em Portugal - Avalia\u00e7\u00e3o do Impacto<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cf51b6b elementor-widget elementor-widget-spacer\" data-id=\"cf51b6b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d273000 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d273000\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-c3a7758\" data-id=\"c3a7758\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-416ca68 elementor-widget elementor-widget-heading\" data-id=\"416ca68\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Sum\u00e1rio Executivo<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b194b57 elementor-widget elementor-widget-text-editor\" data-id=\"b194b57\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p class=\"p2\"><b>Contexto<\/b><\/p><p class=\"p3\">Os programas de\u00a0<i>Patient Blood Management\u00a0<\/i>(PBM), para al\u00e9m de visarem a melhoria dos resultados em sa\u00fade dos doentes, est\u00e3o associados a um menor consumo de recursos e \u00e0 redu\u00e7\u00e3o de custos em Sa\u00fade.<\/p><p class=\"p3\">Reconhecendo a import\u00e2ncia desta tem\u00e1tica e a elevada preval\u00eancia que a anemia apresenta no nosso pa\u00eds, a Associa\u00e7\u00e3o Portuguesa para o Estudo da Anemia juntamente com a EXIGO Consultores, desenvolveram um modelo para avalia\u00e7\u00e3o do impacto da implementa\u00e7\u00e3o de um programa nacional de PBM na sa\u00fade p\u00fablica em Portugal.<\/p><p class=\"p2\"><b>Dados e m\u00e9todos<\/b><\/p><p class=\"p4\">Uma revis\u00e3o orientada da literatura permitiu caracterizar o estado da arte internacional relativo ao PBM e identificar interven\u00e7\u00f5es e \u00e1reas terap\u00eauticas transpon\u00edveis para o contexto nacional.<\/p><p class=\"p4\">O impacto da implementa\u00e7\u00e3o de um programa de PBM a n\u00edvel nacional, no \u00e2mbito da sa\u00fade p\u00fablica, foi estimado atrav\u00e9s de um modelo matem\u00e1tico de an\u00e1lise de decis\u00e3o que compara dois cen\u00e1rios: \u201cpr\u00e1tica cl\u00ednica actual\u201d e \u201ccom implementa\u00e7\u00e3o de PBM\u201d.<\/p><p class=\"p3\">Paralelamente, foi realizado um question\u00e1rio que visou avaliar a import\u00e2ncia relativa das interven\u00e7\u00f5es de PBM seleccionadas, de acordo com as prefer\u00eancias de peritos nacionais.<\/p><p class=\"p4\">A popula\u00e7\u00e3o considerada incluiu doentes assistidos nos cuidados secund\u00e1rios do Servi\u00e7o Nacional de Sa\u00fade Portugu\u00eas nas seguintes \u00e1reas terap\u00eauticas: cirurgia (ortop\u00e9dica, card\u00edaca e urol\u00f3gica), hemorragia uterina an\u00f3mala, gravidez, hemorragia gastrointestinal, oncologia, cardiologia, hemodi\u00e1lise e doen\u00e7a inflamat\u00f3ria intestinal.<\/p><p class=\"p3\"><span class=\"s1\">Para a caracteriza\u00e7\u00e3o de cada um dos cen\u00e1rios, foram considerados indicadores destinados a avaliar: i) efectividade, tais como,\u00a0<\/span>mortalidade intra-hospitalar, anos de vida ganhos e anos de vida ajustados pela incapacidade (DALY)<span class=\"s1\">; ii) actividade assistencial e consumo de recursos de sa\u00fade, incluindo,\u00a0<\/span>dura\u00e7\u00e3o do internamento, taxa de reinternamento a 30-dias, consultas e transfus\u00f5es\/consumo de sangue e iii) impacto econ\u00f3mico-financeiro, decorrente da mortalidade intra-hospitalar prematura, internamento, reinternamento, medicamentos, efeitos adversos e transfus\u00f5es\/componentes do\u00a0<span class=\"s1\">sangue.<\/span><\/p><p class=\"p1\">O modelo foi parametrizado com dados espec\u00edficos de Portugal e com dados provenientes de uma revis\u00e3o sistem\u00e1tica da literatura. Adicionalmente, tanto o modelo como os par\u00e2metros introduzidos foram validados e lacunas de informa\u00e7\u00e3o completadas por um painel de peritos.<\/p><p class=\"p1\">A avalia\u00e7\u00e3o do valor social e econ\u00f3mico de PBM decorre da compara\u00e7\u00e3o da eventual implementa\u00e7\u00e3o deste programa com a \u201cpr\u00e1tica cl\u00ednica actual\u201d, de acordo com os indicadores definidos e para a popula\u00e7\u00e3o abrangida.<\/p><p class=\"p2\"><b>Resultados<\/b><\/p><p class=\"p3\">Estima-se que a implementa\u00e7\u00e3o nacional de PBM possa abranger 384.704 doentes e que, ap\u00f3s um ano, a transfus\u00e3o de CE seja reduzida em 51,2%, o que representa uma diminui\u00e7\u00e3o de mais de 17 mil indiv\u00edduos transfundidos.<\/p><p class=\"p3\">Em termos de efectividade, prev\u00ea-se que o PBM evite 594 mortes prematuras, o que representa um ganho de 1.481 anos de vida e a redu\u00e7\u00e3o de 3.660 DALYs em rela\u00e7\u00e3o \u00e0 pr\u00e1tica cl\u00ednica actual.<\/p><p class=\"p3\">\u00c9 tamb\u00e9m esperada uma redu\u00e7\u00e3o de 8,4% e 37,3% na dura\u00e7\u00e3o do internamento e na taxa de reinternamento. Contudo, o n\u00famero total de consultas m\u00e9dicas poder\u00e1 aumentar 14,4% ap\u00f3s a implementa\u00e7\u00e3o de PBM.<\/p><p class=\"p3\">\u00c9 expect\u00e1vel que a implementa\u00e7\u00e3o de PBM resulte num benef\u00edcio econ\u00f3mico de 67,7 milh\u00f5es de euros (M\u20ac) num ano, o que representa uma redu\u00e7\u00e3o total de custos de 6,3% em rela\u00e7\u00e3o ao paradigma actual. A poupan\u00e7a ao n\u00edvel dos custos do internamento e reinternamento \u00e9 a mais relevante, representando 70,4 M\u20ac, seguindo-se a poupan\u00e7a com o sangue e transfus\u00f5es (17,9 M\u20ac). No entanto, um programa de PBM implica uma gest\u00e3o optimizada da situa\u00e7\u00e3o cl\u00ednica dos doentes, resultando num aumento do n\u00famero de consultas e a um maior consumo de medicamentos. Em conjunto, representam uma despesa adicional de 24,1 M\u20ac.<\/p><p class=\"p1\"><b>Conclus\u00f5es<\/b><\/p><p class=\"p2\">A implementa\u00e7\u00e3o de um PBM a n\u00edvel nacional poder\u00e1 representar um impacto substancial na redu\u00e7\u00e3o da mortalidade intra-hospitalar e carga global das doen\u00e7as associadas (DALY). Embora Portugal n\u00e3o seja um dos pa\u00edses Europeus com maior consumo de sangue\u00a0<i>per capita<\/i>, um programa de PBM representar\u00e1 uma melhoria fundamental nos resultados em sa\u00fade relativos \u00e0 utiliza\u00e7\u00e3o de transfus\u00f5es e suas consequ\u00eancias na dura\u00e7\u00e3o do internamento e na taxa de reinternamento.<\/p><p class=\"p2\">Em suma, todos estes factores representam um elevado valor em termos de sa\u00fade p\u00fablica, o que tamb\u00e9m implica um grande valor econ\u00f3mico para o Servi\u00e7o Nacional de Sa\u00fade, face \u00e0 possibilidade de uma poupan\u00e7a substancial ap\u00f3s um ano da implementa\u00e7\u00e3o de um programa de PBM em Portugal.<\/p><p class=\"p2\">Na eventualidade da implementa\u00e7\u00e3o de um PBM em Portugal, a administra\u00e7\u00e3o de ferro e a estrat\u00e9gia transfusional restritiva de concentrado eritrocit\u00e1rio seriam as interven\u00e7\u00f5es de elei\u00e7\u00e3o de acordo com a opini\u00e3o do grupo de peritos nacionais.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-80d7706\" data-id=\"80d7706\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8ca3be0 elementor-widget elementor-widget-embedpress_pdf\" data-id=\"8ca3be0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"embedpress_pdf.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t    <div class=\"embedpress-document-embed ep-doc-ca66d484f29902b7e9469492d50915d1 ose-document emebedpress-unit-percent \" data-thememode=\"default\" data-customcolor=\"\" data-toolbar=\"yes\" data-toolbar-position=\"top\" data-open=\"no\" data-presentation-mode=\"yes\" data-download=\"yes\" data-copy=\"yes\" data-add-image=\"yes\" data-rotate=\"yes\" data-details=\"yes\" data-id=\"embedpress-pdf-8ca3be0\" data-selection-tool=\"0\" data-scrolling=\"0\" data-spreads=\"-1\" style=\" max-width:100%; 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Avalia\u00e7\u00e3o do Impacto Sum\u00e1rio Executivo Contexto Os programas de\u00a0Patient Blood Management\u00a0(PBM), para al\u00e9m de visarem a melhoria dos resultados em sa\u00fade dos doentes, est\u00e3o associados a um menor consumo de recursos e \u00e0 redu\u00e7\u00e3o de custos em Sa\u00fade. Reconhecendo a import\u00e2ncia desta tem\u00e1tica e a elevada preval\u00eancia que a anemia apresenta&#8230;<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-14178","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>PBM em Portugal - Avalia\u00e7\u00e3o do Impacto - AWGP - Testes<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"pt_PT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"PBM em Portugal - Avalia\u00e7\u00e3o do Impacto - AWGP - Testes\" \/>\n<meta property=\"og:description\" content=\"PBM em Portugal &#8211; Avalia\u00e7\u00e3o do Impacto Sum\u00e1rio Executivo Contexto Os programas de\u00a0Patient Blood Management\u00a0(PBM), para al\u00e9m de visarem a melhoria dos resultados em sa\u00fade dos doentes, est\u00e3o associados a um menor consumo de recursos e \u00e0 redu\u00e7\u00e3o de custos em Sa\u00fade. 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