Custo Direto do Tratamento do Acidente Vascular Cerebral Isquêmico na Perspectiva de um Hospital Público Terciário (Direct Cost of Treating Ischemic Stroke From the Perspective of a Tertiary Public Hospital).

Autor: de Almeida JTC; Departamento de Gestão de Atividade Acadêmicas, Hospital das Clínicas da Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brasil., Bazan R; Departamento de Neurologia, Psicologia, Psiquiatria, Universidade Estadual Paulista, UNESP, Faculdade de Medicina, Botucatu, São Paulo, Brasil., Silva SN; Núcleo de Avaliação de Tecnologias em Saúde do Instituto René Rachou-Fundação Oswaldo Cruz-FIOCRUZ, Belo Horizonte, Minas Gerais, Brasil., Silva LF; Departamento de Clínica Médica, Universidade Estadual Paulista, UNESP, Faculdade de Medicina, Botucatu, São Paulo, Brasil., Rugolo JM; Departamento de Gestão de Atividade Acadêmicas, Hospital das Clínicas da Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brasil., de Sordi MAP; Departamento de Gestão de Atividade Acadêmicas, Hospital das Clínicas da Faculdade de Medicina de Botucatu, Botucatu, São Paulo, Brasil., de Freitas CCM; Departamento de Neurologia, Psicologia, Psiquiatria, Universidade Estadual Paulista, UNESP, Faculdade de Medicina, Botucatu, São Paulo, Brasil., Nunes-Nogueira VDS; Departamento de Clínica Médica, Universidade Estadual Paulista, UNESP, Faculdade de Medicina, Botucatu, São Paulo, Brasil. Electronic address: vania.nunes-nogueira@unesp.br.
Jazyk: angličtina
Zdroj: Value in health regional issues [Value Health Reg Issues] 2024 Nov; Vol. 44, pp. 101019. Date of Electronic Publication: 2024 Jun 25.
DOI: 10.1016/j.vhri.2024.101019
Abstrakt: Objectives: To measure the direct cost of treating acute ischemic stroke (IS) from the perspective of a public hospital in Brazil (HCFMB) and compare it with the reimbursement by the Unified Health System (SUS), through the Procedure Table Management System, Medicines, Orthoses/Prostheses and Special Materials of the Unified Health System (SIGTAP).
Methods: We performed a micro-costing study; four scenarios were evaluated: standard (1); alteplase (2); alteplase and mechanical thrombectomy (3); mechanical thrombectomy (4). Based on the number of patients hospitalized for ischemic stroke in 2019, hospital cost, and SUS billing were calculated for each scenario. Hospital costs were adjusted for inflation using CCEMG-EPPI-Centre Cost Converter.
Results: In 2019, 258 patients were hospitalized due to IS, 89.5% in scenario 1, 8% in scenario 2, 1.5% in scenario 3, 1% in scenario 4. From the hospital's perspective, the cost per patient was estimated at R$7780.13, R$15 741.23, R$28 988.49, R$25 739.79, for scenarios 1, 2, 3 and 4, respectively. The reimbursement by SIGTAP was estimated at R$3079.87, R$5417.21, R$10 901.92, R$10 286.28, respectively. If thrombectomy had been included in the SIGTAP, the last two values would be R$25 393.34 and R$24 248.89.
Conclusions: The hospital cost of treating acute IS in 2019 was estimated at R$2 295 209, the SUS reimbursement at R$889 391.54. With the inclusion of thrombectomy at SIGTAP, this reimbursement would be R$975 282.44, and the loss in the cost of HCFMB per patient in relation to reimbursement by the SUS is greater in scenarios without this procedure.
Competing Interests: Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section.
(Copyright © 2024 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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