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)

被引：0

作者：

Almeida, Juliana Tereza Coneglian de ^{[1
]}

Bazan, Rodrigo ^{[1
,2
]}

Silva, Sarah Nascimento ^{[3
]}

Silva, Lukas Fernando ^{[4
]}

Rugolo, Juliana Machado

de Sordi, Monica Aparecida de Paula ^{[1
]}

de Freitas, Carlos Clayton Macedo ^{[2
]}

Nunes-Nogueira, Vania dos Santos ^{[4
]}

机构：

[1] Hosp Clin, Fac Med Botucatu, Dept Gestao Atividade Academ, Botucatu, SP, Brazil

[2] Univ Estadual Paulista UNESP, Fac Med, Dept Neurol Psicol Psiquiatria, Botucatu, SP, Brazil

[3] Fundacao Oswaldo Cruz FIOCRUZ, Nucleo Avaliacao Tecnol Saude Inst Rene Rachou, Belo Horizonte, MG, Brazil

[4] Univ Estadual Paulista UNESP, Fac Med, Dept Clin Med, Botucatu, SP, Brazil

来源：

VALUE IN HEALTH REGIONAL ISSUES | 2024年 / 44卷

关键词：

costs; endovascular treatment; ischemic stroke; mechanical thrombectomy; BRAZIL;

D O I：

10.1016/j.vhri.2024.101019

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

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 Uni fied Health System (SUS), through the Procedure Table Management System, Medicines, Orthoses/Prostheses and Special Materials of the Uni fied 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 in flation 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.

引用

页数：6