Bittar Eliana, Castilho Valéria
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
Universidade de São Paulo, Escola de Enfermagem, Departamento de Orientação Profissional, São Paulo, SP, Brazil.
Rev Esc Enferm USP. 2017 Oct 9;51:e03246. doi: 10.1590/S1980-220X2016050503246.
Identifying the average direct cost of TAVI (Transcatheter Aortic Valve Implantation) for the different access routes.
This is a research with a quantitative, exploratory and descriptive approach carried out in a government teaching hospital in the state of São Paulo.
The average direct cost of TAVI procedures by the access routes resulted in R$82,826.38 (transfemoral route), R$79,440.91 (transaortic route) and R$78,173.41 (transapical route). The transcatheter valve cost represented a percentage variation between 78.47% and 83.14% of the total cost of the procedure. The Kruskal-Wallis test was used and presented a statistically significant difference between the three access routes: p=0.008. The Bonferroni test showed a difference in the association between transfemoral and transapical routes, while no statistically significant difference was observed in association with the transaortic route.
The results are important for formulating adequate funding policies for the hospital network and understanding the costs according to the route facilitates rationalizing resources in order for them to be guaranteed for patients who present surgical contraindication to the valve implant.
确定经导管主动脉瓣植入术（TAVI）不同入路的平均直接成本。
这是一项在圣保罗州一家政府教学医院开展的采用定量、探索性和描述性方法的研究。
TAVI手术不同入路的平均直接成本分别为：经股动脉入路82,826.38雷亚尔，经主动脉入路79,440.91雷亚尔，经心尖入路78,173.41雷亚尔。经导管瓣膜成本占手术总成本的百分比在78.47%至83.14%之间。使用了克鲁斯卡尔 - 沃利斯检验，结果显示三种入路之间存在统计学显著差异：p = 0.008。邦费罗尼检验表明经股动脉和经心尖入路之间存在关联差异，而与经主动脉入路相关联时未观察到统计学显著差异。
这些结果对于制定医院网络的适当资金政策很重要，并且根据入路了解成本有助于合理配置资源，以便为存在瓣膜植入手术禁忌证的患者提供保障。
