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巴西统一卫生系统在一家联邦三级医院通过腹腔镜进行肥胖症外科治疗的费用。

COSTS FOR THE SURGICAL TREATMENT OF OBESITY THROUGH LAPAROSCOPY IN A FEDERAL TERTIARY HOSPITAL BY THE BRAZILIAN UNIFIED HEALTH SYSTEM.

作者信息

Ferraz Álvaro Antonio Bandeira, Medeiros Hiago Dantas, Santa-Cruz Fernando, Kreimer Flávio

机构信息

Universidade Federal de Pernambuco, Department of Surgery - Recife (PE), Brazil.

Universidade Federal de Pernambuco, University Hospital, General Surgery Residence - Recife (PE), Brazil.

出版信息

Arq Bras Cir Dig. 2024 Dec 2;37:e1836. doi: 10.1590/0102-6720202400042e1836. eCollection 2024.

Abstract

BACKGROUND

Obesity is a multifactorial disease affecting a significant portion of the population. Bariatric surgery emerges as a prominent approach in this context, representing an effective treatment both in the short and long term. The costs associated with bariatric surgery vary depending on the characteristics of the patients, current hospital practices, and available funding sources.

AIMS

To analyze the costs of minimally invasive bariatric surgery for the treatment of obesity in a tertiary federal public hospital.

METHODS

An observational and descriptive study aimed at assessing the costs associated with laparoscopic vertical gastrectomy (GV) and Roux-en-Y gastric bypass (RYGB) in a federal public tertiary service from 2018 to 2021. Data were obtained through the management of medical-hospital expenses related to surgical and anesthetic supplies, as well as the amount reimbursed by the funding source to the hospital.

RESULTS

Over the analyzed period, a total of 177 minimally invasive bariatric surgeries were performed. In terms of the charges, since 2018, the hospital has been receiving an amount of R$ 6,145.00 for the "bariatric surgery by videolaparoscopy" procedure, which includes RYGB, and R$ 4,095.00 for "vertical gastrectomy." Regarding the average hospital cost of surgical supplies, RYGB incurred a total of R$ 9,907.54, while GV incurred a total of R$ 9,315.84. The average total cost of RYGB was R$ 10,799.23, and, for GV, it was R$ 10,207.53. These figures indicate that the hospital incurred a loss of approximately R$ 4,654.23 for performing RYGB and R$ 6,112.53 for GV.

CONCLUSION

Despite the increasing number of eligible patients for surgical treatment of obesity and the consequent quantitative growth of these procedures funded by the Brazilian Unified Health System (SUS), the costs exceed the reimbursement from the funding source in federal public hospitals. There is a need for a precise assessment of financing in the fight against obesity.

摘要

背景

肥胖是一种影响相当一部分人口的多因素疾病。在这种情况下,减肥手术成为一种突出的方法,在短期和长期内都是一种有效的治疗方法。与减肥手术相关的费用因患者特征、当前医院做法和可用资金来源而异。

目的

分析一家联邦三级公立医院进行的微创减肥手术治疗肥胖症的费用。

方法

一项观察性和描述性研究,旨在评估2018年至2021年在一家联邦三级公立医院进行腹腔镜垂直胃切除术(GV)和Roux-en-Y胃旁路术(RYGB)的相关费用。数据通过管理与手术和麻醉用品相关的医疗费用以及资金来源向医院报销的金额获得。

结果

在分析期间,共进行了177例微创减肥手术。在收费方面,自2018年以来,医院对包括RYGB在内的“腹腔镜减肥手术”程序收取6145.00雷亚尔,对“垂直胃切除术”收取4095.00雷亚尔。关于手术用品的平均医院成本,RYGB总计9907.54雷亚尔,而GV总计9315.84雷亚尔。RYGB的平均总成本为10799.23雷亚尔,GV的平均总成本为10207.53雷亚尔。这些数字表明,医院进行RYGB亏损约4654.23雷亚尔,进行GV亏损6112.53雷亚尔。

结论

尽管有资格接受肥胖症手术治疗的患者数量不断增加,巴西统一卫生系统(SUS)资助的这些手术数量也随之增长,但联邦公立医院的成本超过了资金来源的报销额。在抗击肥胖症方面需要对资金进行精确评估。

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