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巴西统一卫生系统(SUS)对冠状动脉旁路移植手术费用的覆盖情况。

Coronary Artery Bypass Graft Surgery Cost Coverage by the Brazilian Unified Health System (SUS).

作者信息

Silva Gilmara Silveira da, Colósimo Flávia Cortez, Sousa Alexandre Gonçalves de, Piotto Raquel Ferrari, Castilho Valéria

机构信息

Real e Benemérita Associação Portuguesa de Beneficência (Hospital Beneficência Portuguesa de São Paulo), São Paulo, SP, Brazil.

Escola de Enfermagem da Universidade de São Paulo (EE-USP), São Paulo, SP, Brazil.

出版信息

Braz J Cardiovasc Surg. 2017 Jul-Aug;32(4):253-259. doi: 10.21470/1678-9741-2016-0069.

Abstract

INTRODUCTION

Cost management has been identified as an essential tool for the general control and evaluation of health organizations.

OBJECTIVES

To identify the coverage percentage of transferred funds from the Unified Health System for coronary artery bypass grafts in a philanthropic hospital having a consolidated costing system in the municipality of São Paulo.

METHODS

A quantitative, descriptive and cross-sectional research with information provided from a database composed of 1913 patients undergoing coronary artery bypass graft from March 13 to September 30, 2012, including isolated elective coronary artery bypass graft with the use of extracorporeal circulation. It excluded 551 (28.8%) patients, among them 76 (4.0%) deaths and 8 hospitalized patients, since the cost was compared according to the length of hospital stay. Therefore, the sample consisted of 1362 patients.

RESULTS

The average total cost per patient was $7,992.55. The average fund transfer by the Unified Health System was $3,450.73 (48.66%), resulting in a deficit of $4,541.82 (51.34%).

CONCLUSION

The Unified Health System transfers covered 48.66% of the average total cost of hospitalization. Although the amount transferred increased with increasing costs, it was not proportional to the total cost, resulting in a percentage difference in revenue that was increasingly negative for each increase in cost and hospital stay. Those hospitalized for longer than seven days presented higher costs, older age, higher percentage of diabetics and chronic kidney disease patients and more postoperative complications.

摘要

引言

成本管理已被视为卫生组织总体控制与评估的一项重要工具。

目的

确定在圣保罗市一家拥有综合成本核算系统的慈善医院中,统一卫生系统为冠状动脉搭桥手术所转移资金的覆盖百分比。

方法

采用定量、描述性和横断面研究方法,信息来源于一个数据库,该数据库包含2012年3月13日至9月30日期间接受冠状动脉搭桥手术的1913例患者,包括使用体外循环的单纯择期冠状动脉搭桥手术。排除了551例(28.8%)患者,其中76例(4.0%)死亡患者和8例住院患者,因为成本是根据住院时间进行比较的。因此,样本由1362例患者组成。

结果

每位患者的平均总成本为7992.55美元。统一卫生系统的平均资金转移额为3450.73美元(48.66%),导致赤字4541.82美元(51.34%)。

结论

统一卫生系统的转移资金覆盖了住院平均总成本的48.66%。尽管转移金额随成本增加而增加,但与总成本不成比例,导致成本和住院时间每增加一次,收入百分比差异就愈发为负。住院超过七天的患者成本更高、年龄更大、糖尿病患者和慢性肾病患者的比例更高,术后并发症更多。

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