Estratificação de risco na organização do atendimento à saúde da pessoa com Diabetes Mellitus

Abstract

Diabetes Mellitus (DM), a chronic disease that is described by several authors as a pandemic with increasing proportions. Considering the epidemiological context, attention to the person with DM has actions implemented throughout the emergence of the Unified Health System, mainly in the scope of Primary Care (AB). Stratify the care regarding the risk, is a proposal to organize a care directed to the needs of the person with chronic disease, specifically Diabetes Mellitus. This research has the objective of classifying the Risk Stratification for the care of people with Diabetes Mellitus of a Basic Health Unit. A cross-sectional, quantitative study with the participation of 75 people with DM attended at the Basic Health Unit of the Federal University of Amapá / UNIFAP, and data collection was performed using an instrument containing sociodemographic and clinical variables and Risk Stratification based on the proposal of Sturmer and Biachinni (in press, 2012) and Cavalcanti et. Al. (2010), according to recommendations of Mendes (2012), that in its Model of Attention Chronic Conditions / MACC, which establishes strata of risks from 1 to 5. The analysis of the data occurred through the Statistical Package for the Social Sciences (SPSS) Version 22. This study was approved by opinion nº. 1,337,669 in compliance with the recommendations of Resolution nº. 466/2012 of the National Health Council (CNS). Sociodemographic results were 79% female, with an average age of 56.7 (± 11), 32% had incomplete elementary school, 24% were retired and had a family income of 75% from one to three minimum wages. Regarding clinical variables, life habits, 55% performed physical activity, 40% did not smoke or drink; Antecedents, 73% have arterial hypertension in the family, and 88% are hypertensive; On physical examination, 54% abnormal heart auscultation, and 58% did not perform physical examination of the feet. The Body Mass Index was 42% overweight, with 73% with Abdominal Circumference substantially increased. Blood pressure was altered by 46%. To the laboratory tests, 51% were with altered fasting glucose. The Fragmingham score had 47% scored at low risk. With the proposed general objective, 38% were in Stratum 4, high risk, with complex chronic disease with capacity for self-care, with difficulty in adhering to treatment, injuries in other organs, but still able to develop their self care, Multiprofessional, that is, the same day and shift, going through all the professionals. This result corresponds to a high percentage of individuals who need a focused and multiprofessional attention in Primary Care, to prevent injuries and for secondary / tertiary referrals to be reduced and DM mortality avoided. Stratifying the risk that diabetes represents the individual according to his needs, will help the professional to improve the quality of the service to be offered to this population