Cost-effectiveness analysis of hernioplasties before and after the implementation of the ACERTO project.

Autor:	Nascimento JEA; UNIVAG, Várzea Grande, MT, Brasil., SalomÃo AB; Hospital Universitário Julio Muller, Programa de Pós-Graduação em Ciências Aplicadas à Atenção Hospitalar, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil., Ribeiro MRR; Hospital Universitário Julio Muller, Programa de Pós-Graduação em Ciências Aplicadas à Atenção Hospitalar, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil., Silva RFD; Hospital Universitário Julio Muller, Programa de Pós-Graduação em Ciências Aplicadas à Atenção Hospitalar, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil., Arruda WSC; Pós-graduação em Ciências da Saúde, Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil.
Jazyk:	Portuguese; English
Zdroj:	Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2020; Vol. 47, pp. e20202438. Date of Electronic Publication: 2020 Aug 12.
DOI:	10.1590/0100-6991e-20202438
Abstrakt:	Objective: to compare hospital costs and clinical outcomes in inguinal and incisional hernioplasty before and after implementation of the ACERTO project in a university hospital. Methods: retrospective study of 492 patients undergoing either inguinal hernioplasty (n=315) or incisional hernioplasty (n=177). The investigation involved two phases: between January 2002 and December 2005, encompassing cases admitted before the implementation of the ACERTO protocol (PRE-ACERTO period), and the other phase, with cases operated between January 2006 and December 2011, after the implementation of the protocol (ACERTO period). The main outcome variable was the comparison of the mean hospital costs between the two periods. As secondary endpoints, we analyzed the length of stay, the surgical site infection rate and mortality. We used the cost method suggested by Public Sector Cost Information System. Results: surgical site infection was higher (p = 0.039) in the first phase of the study for both inguinal hernia operations (2 (1.6%) versus 0 (0%) cases) and incisional hernioplasty (5 (7.6%) versus 3 (2.7%) cases). The length of stay decreased one day after the implementation of the ACERTO protocol (p=0.005). There was a reduction in costs per patient from R$ 4,328.58 per patient in the first phase to R$ 2,885.72 in the second phase (66.7% reduction). Conclusion: there was a reduction in infectious morbidity, length of stay and hospital costs in hernioplasty after the implementation of the ACERTO protocol.
Databáze:	MEDLINE
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