1999 年至 2008 年巴西里约热内卢州公共卫生系统（SUS）的冠状动脉旁路移植术的表现和成本。

Coronary artery bypass graft surgery performance and costs by the Brazilian Public Health System (SUS) in the State of Rio de Janeiro, from 1999 to 2008.

机构信息

Universidade Federal do Rio de Janeiro, RJ, Brasil.

出版信息

Arq Bras Cardiol. 2011 Oct;97(4):297-306. doi: 10.1590/s0066-782x2011005000108. Epub 2011 Oct 21.

DOI:10.1590/s0066-782x2011005000108

PMID:22011805

Abstract

BACKGROUND

Expenses with coronary artery bypass grafting (CABG) surgery and coronary angioplasty (CA) represented a significant cost to SUS.

OBJECTIVE

To analyze SUS expenses with CABG and CA and their performance in hospitals in the state of Rio de Janeiro (SRJ), from 1999 to 2008.

METHODS

The information came from paid HAA in hospitals with more than 100 revascularization procedures. Mortality rates were adjusted by Poisson (with covariates age, length of hospital stay and ICU expenses). Mean relative cost indices were calculated by dividing the mean value of the cost fraction spent in each hospital by the mean expense in the SRJ in U.S. dollars. Stata software was used for statistical analysis.

RESULTS

A total of 10,983 CABG and 19,661 CA were paid by SUS in 20 hospitals during the 10 years, with mean values of US$ 3,088.12 and 2,183.93, respectively. The mortality rate in CABG varied from 9.2%-1999 to 7.7%-2008, with ranges of 5.0%-9.2% and in CA, from 1.6%-1999 to 1.5%-2008, with ranges of 0.9%-2.3%. The hospitals decreased the number of CABG procedures and doubled CA procedures. Age, time of hospital stay and ICU costs significantly correlated with lethality in CABG and CA paid by SUS in the SRJ. On average, hospital service costs represented 41% of the total cost of CABG and 18% of CA, and with ortheses and prostheses, 55% in CA and 28% in CABG.

CONCLUSION

It is clear the need to improve the quality of healthcare service in institutions that perform CABG and CA paid by SUS.

摘要

背景

冠状动脉旁路移植术（CABG）和冠状动脉成形术（CA）的费用对巴西的全民健康保险制度（SUS）来说是一笔巨大的开支。

目的

分析 1999 年至 2008 年巴西里约热内卢州（SRJ）SUS 为 CABG 和 CA 支付的费用及其在医院的表现。

方法

该信息来自于在有超过 100 例血运重建手术的医院中支付的 HAA。死亡率通过泊松分布（协变量为年龄、住院时间和 ICU 费用）进行调整。通过将每个医院的费用部分的平均值除以美元计算平均相对成本指数。使用 Stata 软件进行统计分析。

结果

在 10 年间，20 家医院共有 10983 例 CABG 和 19661 例 CA 由 SUS 支付，其平均值分别为 3088.12 美元和 2183.93 美元。CABG 的死亡率从 1999 年的 9.2%降至 2008 年的 7.7%，范围为 5.0%-9.2%，而 CA 的死亡率从 1999 年的 1.6%降至 2008 年的 1.5%，范围为 0.9%-2.3%。医院减少了 CABG 手术数量，同时增加了 CA 手术数量。年龄、住院时间和 ICU 费用与 SUS 在 SRJ 支付的 CABG 和 CA 的致死率显著相关。平均而言，医院服务费用占 CABG 总费用的 41%，CA 的 18%，而矫形和假肢费用，CA 占 55%，CABG 占 28%。