Abstract
The objective of this study was to estimate the number of psychiatric beds occupied per State in Brazil and the amount paid by the Unified National Health System (SUS) for hospitalizations, professional services, tests, and medicines in the country in 2004. The mean number of psychiatric beds occupied, estimated on the basis of total days of hospitalization during the year, and the amount paid by the SUS were obtained from the Hospital Admissions Authorizations (AIH). A total of 45 thousand psychiatric beds were occupied by the SUS in 2004. The SUS paid a total of BRL$487 million (some U$270 million) for hospitalization of patients with mental disorders in 2004. Private hospitals accounted for 78.8% of all psychiatric beds occupied by the SUS. Although the deactivation of 15 mil psychiatric beds could currently generate BRL$162 million (U$90 million) to be reallocated to non-hospital psychiatric services, planning and implementation of the Psychiatric Reform have been very limited. The precarious extra-hospital network has been used as a barrier to deactivation of psychiatric beds, although the latter generates the necessary resources for the former.
Highlights
A adequação dos hospitais psiquiátricos e seus métodos terapêuticos foram radicalmente questionados na década de 1960 por Franco Basaglia; e a Itália, em 1978, foi o primeiro país do mundo a aprovar uma lei antimanicomial 1
The objective of this study was to estimate the number of psychiatric beds occupied per State in Brazil and the amount paid by the Unified National Health System (SUS) for hospitalizations, professional services, tests, and medicines in the country in 2004
The mean number of psychiatric beds occupied, estimated on the basis of total days of hospitalization during the year, and the amount paid by the SUS were obtained from the Hospital Admissions Authorizations (AIH)
Summary
Fonte: Departamento de Informática do SUS 6,7,11. Nota: 47.911 leitos SUS e 8.672 não SUS (total 56.583) em 04 de agosto de 2005 de acordo com Cadastro Nacional de Estabelecimentos de Saúde 8. * Leitos cadastrados em julho; ** Leitos ocupados (média anual): dias de permanência divididos por 365. 1a) Leitos psiquiátricos ocupados/Sistema Único de Saúde (SUS) por mil habitantes. 1b) Percentual de leitos psiquiátricos no total de leitos ocupados/Sistema Único de Saúde (SUS) por mil habitantes. O Ministério da Saúde estima que 15 mil pacientes asilares são potencialmente beneficiários de desinstitucionalização 5. De acordo com a Tabela 4, 78,8% do total de leitos psiquiátricos ocupados pelo SUS em 2004 eram privados. Entre os 67 hospitais com mais de 200 leitos psiquiátricos ocupados, 55 eram privados, 11 estaduais e um municipal. Os hospitais com mais de 200 leitos ocuparam 51,1% dos 45.194 leitos psiquiátricos e receberam R$ 231 milhões do SUS por serviços hospitalares, profissionais e SADT em 2004. Tabela 2 Leitos psiquiátricos ocupados/Sistema Único de Saúde (SUS) por especialidade e data de internação.
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