The UPA 24 hours project was based on the Ministry of Health National Urgency and Emergency Policy. The UPA 24 hours is a health unit which works nonstop, serving users in the specialties of medical and pediatric clinics, characterized as a fixed pre-hospital service - “ambulance without wheels” -specific for small and medium urgencies and emergencies, including dental, in addition to being prepared for the care of critically ill patients, until they are transferred to a referral hospital. It is a concept of an intermediate health unit, between the health unit and the hospital. The red room is dedicated to assisting cardiovascular diseases, respiratory emergencies and cardiopulmonary arrest (CPA), this way it resembles an intensive care unit. The length of stay of the red room users increase, had a negative impact on the turnover of beds according to the established quality indicators. There was an assumption that the cost increase, as the risks of comorbidity and adverse health events could go up, compromising a greater allocation of human resources, increased use of inputs and, lastly, soaring the unit's mortality rate. Given the above and the need to make health economics an ally in the decision-making process, the present study aims to achieve the cost minimization of the time spent by users at UPA 24h, under the Coordination of CAP 3.1
MATERIALS AND METHODS:
This is an economic health evaluation study that used cost analysis with the use of a decision tree software in order to compare the impact of users' time spent in the red room of three different UPAs 24 hours from the Coordination Programmatic Area (CAP) 3.1 of Rio de Janeiro State.
We observed a discrepancy in the average cost per user assisted at each UPA over 1 year, reaching to a significant difference between the highest and lowest value. In a sensitivity analysis, the variables that impacted the total costs of the UPAs were: the time < 24h and cardiovascular diseases, regarding the three UPAs. UPA #1 presented 30% of its budget committed, UPA# 2 presented 18% and UPA #3 7%.
Considering this is an unprecedented study, we do hope this topic will be the study object of further studies for Nursing in the area of Emergency care management at UPA 24h.