Leandro Reis Tavares

Custo da insuficiência cardíaca no Sistema Único de Saúde

Heart failure is the major cause of hospitalization in Unified Health System - Sistema Unico de Saude (SUS), from 65 years of age. The prevalence of heart failure is ascending, arising out of the increase in life expectancy of our population and a greater effectiveness of new medications for the treatment, which extends life. There are few national studies for the dimensioning of the socioeconomic impact and epidemiology of heart failure. There is the need for implementing economic methods to estimate the costs, instead of simply incurring expenses with heart failure. The estimate of the socioeconomic impact of the syndrome will provide the health policy formulators with a greater base for decisionmaking, before a scenario of lack of funds and need for prioritizing in its allocation. Stewart et al. 1OBJECTIVE To describe the direct and indirect costs of ambulatory and in-patient treatments of heart failure during 2002, in the University Hospital Antonio Pedro, Niterói. METHODS A cross-sectional and retrospective study on utilization and valuation of resources in 70 patients, consecutively selected, under ambulatory and in-patient treatment. Questionnaires and records of the patients were used for data collection. The resources used were evaluated in Brazilian Reais (2002). The studys point of view was the perspective from society. The data were analyzed in the EPINFO program, 2002 version. RESULTS The studied population consisted of 70 patients (39 women), with average age of 60.3 years old. 465 in-patients days (28.5% of the patients) took place. There were 386 ward hospitalizations and 79 in ICUs. The cost with ambulatory appointments was R

Epidemiologia da insuficiência cardíaca descompensada em Niterói: Projeto EPICA - Niterói

14.40. The expenses with ambulatory medications amounted R

Insuficiência cardíaca com fração de ejeção preservada e com disfunção sistólica na comunidade

83,430.00 (R

Associação da síndrome metabólica e seus componentes na insuficiência cardíaca encaminhada da atenção primária

1,191.86/patient/year). The cost per hospitalized patient was R

Response of blood pressure to maximum exercise in hypertensive patients under different therapeutic programs

4,033.62. The cost with complementary examinations totaled R

Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors

39,009.50 (R

Perceptions of Heart Failure Diagnosis and Management: Comparison between Clinical Cardiologists and Family Doctors

557.28/patient/year). Twenty patients retired due to heart failure, which represented a loss in productivity of R

Teste de esforço em hipertensos em uso de diferentes inibidores da enzima conversora da angiotensina

182,000.00. The total cost was R

Características clínicas e demográficas e perfil terapêutico de pacientes hospitalizados com fibrilação atrial: estudo EPIFA

444,445.20. Hospitalization represented 39.7% and the use of medications 38.3% from direct costs. CONCLUSION The hospitalization cost and the expenses with medications represented the main components of direct costs. Indirect costs represented economic impacts similar to direct costs.

Características Clínicas e Demográficas e Perfil Terapêutico de Pacientes Hospitalizados com Fibrilação Atrial: Estudo EPIFA Clinic and Demographic Characteristics and Therapeutic Profile of Hospitalized Patients with Atrial Fibrillation: The EPIFA Study

OBJECTIVE To compare the epidemiological and socioeconomic profiles, clinical features, etiology, length of hospitalization, and mortality of patients with decompensated heart failure admitted to public and private hospitals in the city of Niterói. METHODS We carried out a prospective, multicenter study (from July to September 2001) comprising all patients older than 18 years with the primary diagnosis of heart failure and admitted to hospitals in the city of Niterói, whose scores according to the Boston criteria were 8 or above. Proportions were compared using the chi-square and Fisher exact tests. RESULTS The sample comprised 203 patients as follows: 1) 98 patients from public hospitals: 50% were men, their mean age was 61.1+/-11.3 years, 65% were black, 57% had an income of 1 minimum wage or less, 56% were illiterate, 66% had ischemic heart disease, their mean length of hospitalization was 12.6 days, and the mortality rate adjusted for age was 5.23; 2) 105 patients from private hospitals: 49% were men, their mean age was 72+/-12.7 years, 20% were black, 58% had an income greater than 6 minimum wages, 11% were illiterate, 62% had ischemic heart disease, their mean length of hospitalization was 8 days, and the mortality rate adjusted for age was 2.94. The distribution of comorbidities and risk factors was similar among the patients of the 2 hospital systems, except for the smoking habit, which was more frequent among patients from public hospitals. CONCLUSION In addition to the socioeconomic asymmetries, the hospitalization length and the mortality rate adjusted for age were greater in patients in the public health system.OBJECTIVE: To compare the epidemiological and socioeconomic profiles, clinical features, etiology, length of hospitalization, and mortality of patients with decompensated heart failure admitted to public and private hospitals in the city of Niteroi. METHODS: We carried out a prospective, multicenter study (from July to September 2001) comprising all patients older than 18 years with the primary diagnosis of heart failure and admitted to hospitals in the city of Niteroi, whose scores according to the Boston criteria were 8 or above. Proportions were compared using the chi-square and Fisher exact tests. RESULTS: The sample comprised 203 patients as follows: 1) 98 patients from public hospitals: 50% were men, their mean age was 61.1±11.3 years, 65% were black, 57% had an income of 1 minimum wage or less, 56% were illiterate, 66% had ischemic heart disease, their mean length of hospitalization was 12.6 days, and the mortality rate adjusted for age was 5.23; 2) 105 patients from private hospitals: 49% were men, their mean age was 72±12.7 years, 20% were black, 58% had an income greater than 6 minimum wages, 11% were illiterate, 62% had ischemic heart disease, their mean length of hospitalization was 8 days, and the mortality rate adjusted for age was 2.94. The distribution of comorbidities and risk factors was similar among the patients of the 2 hospital systems, except for the smoking habit, which was more frequent among patients from public hospitals. CONCLUSION: In addition to the socioeconomic asymmetries, the hospitalization length and the mortality rate adjusted for age were greater in patients in the public health system.