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Gestão de resíduos de serviço de saúde: mensuração do custo em centro cirúrgico; Waste management of the health service: measurement of cost in the operating room

Nogueira, Danielly Negrão Guassú
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 02/07/2014 PT
Relevância na Pesquisa
46.17%
Os objetivos deste estudo foram mapear e validar os subprocessos do manejo de Resíduos de Serviços de Saúde (RSS) no Centro Cirúrgico (CC).Calcular o custo dos materiais, a taxa de geração e proporção em Kg/nº cirurgia por especialidade, local de geração e por grupos segregados. Trata-se de uma pesquisa exploratória descritiva, de abordagem quantitativa na modalidade de estudo de caso. O local foi o CC do Hospital Universitário da Universidade São Paulo. Considerando o número de cirurgias realizadas nos últimos quatro anos, calculou-se a amostra probabilística estratificada com o poder amostral de 95%. A amostra final foi de 1120 cirurgias. Na coleta de dados foram mapeados os subprocessos de RSS (A, B, D e E) baseada na classificação da RDC 306/04 da ANVISA. Os resíduos foram pesados diariamente por 82 dias, com a colaboração de oito coletadoras, considerando o local de geração e o grupo dos RSS. Para mensuração do custo descreveu-se os subprocesso dos RSS, identificou-se os executores, desenhou-se os fluxogramas, levantamentou-se a quantidade e o custo dos materiais, identificou-se os direcionadores (nº cirurgia) e calculou-se o custo total de cada subprocesso. Os RSS do CC representaram 6,38 % comparado com a produção total do HU-USP. O grupo mais representativo foi o A- infectantes (50...

Otimização de estruturas de destilação azeotrópica com recurso a planeamento experimental

Mendonça, Manuel José Vaz
Fonte: Instituto Politécnico de Lisboa Publicador: Instituto Politécnico de Lisboa
Tipo: Dissertação de Mestrado
Publicado em /12/2013 POR
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45.98%
O etanol é atualmente considerado como a alternativa mais promissora relativamente aos combustíveis fósseis, cada vez mais escassos. A obtenção do etanol pelo processo fermentativo, a partir de matérias-primas disponíveis em abundância, como o milho, a cana do açucar e a madeira, destaca-se como sendo o de produção em maior escala, obtendo-se concentrações relativamente baixas desse composto. De forma a que o etanol produzido nestas condições possa substituir os tradicionais combustíveis, ainda que de modo parcial, revela-se necessário proceder à sua concentração para valores bastante mais elevados, de modo a cumprir com o imposto pelas várias normas aplicáveis. Existem diversos processos que permitem obter os valores de pureza exigidos, sendo que a destilação é, de longe, o processo mais utilizado. Efetivamente, pese embora o facto de este processo ser extremamente intensivo na perspetiva energética, o conhecimento acumulado existente sobre o mesmo, a sua versatilidade e a viabilidade de produção em larga escala, constituem argumentos de relevância considerável que o diferenciam relativamente aos restantes. A concentração do etanol pelo processo destilativo é...

Cyclosporine versus tacrolimus: cost-effectiveness analysis for renal transplantation in Brazil

Guerra Júnior,Augusto Afonso; Silva,Grazielle Dias; Andrade,Eli Iola Gurgel; Cherchiglia,Mariângela Leal; Costa,Juliana de Oliveira; Almeida,Alessandra Maciel; Acurcio,Francisco de Assis
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
Relevância na Pesquisa
46.14%
OBJECTIVE To analyze the cost-effectiveness of treatment regimens with cyclosporine or tacrolimus, five years after renal transplantation. METHODS This cost-effectiveness analysis was based on historical cohort data obtained between 2000 and 2004 and involved 2,022 patients treated with cyclosporine or tacrolimus, matched 1:1 for gender, age, and type and year of transplantation. Graft survival and the direct costs of medical care obtained from the National Health System (SUS) databases were used as outcome results. RESULTS Most of the patients were women, with a mean age of 36.6 years. The most frequent diagnosis of chronic renal failure was glomerulonephritis/nephritis (27.7%). In five years, the tacrolimus group had an average life expectancy gain of 3.96 years at an annual cost of R$78,360.57 compared with the cyclosporine group with a gain of 4.05 years and an annual cost of R$61,350.44. CONCLUSIONS After matching, the study indicated better survival of patients treated with regimens using tacrolimus. However, regimens containing cyclosporine were more cost-effective.

The Estimated Annual Cost of ADHD to the U.S. Education System

Robb, Jessica A.; Sibley, Margaret H.; Pelham, William E.; Foster, E. Michael; Molina, Brooke S.G.; Gnagy, Elizabeth M.; Kuriyan, Aparajita B.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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The purpose of this study was to examine and monetize the educational outcomes of students with ADHD. Data were examined from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of children diagnosed with ADHD in childhood and recontacted for follow-up in adolescence and young adulthood. A comprehensive educational history was obtained for all participants from Kindergarten through 12th grade. Annual economic impact was derived from costs incurred through special education placement, grade retention, and disciplinary incidents. Results indicated that, as compared to students without ADHD, students with ADHD incurred a higher annual cost to the U.S. Education system. Specifically, a student with ADHD incurred an average annual incremental cost to society of $5,007, as compared to $318 for students in the comparison group. These results suggest that prevention and intervention strategies are greatly needed to offset the large financial impact of educating youth with ADHD.

Hypertension education and adherence in South Africa: a cost-effectiveness analysis of community health workers

Gaziano, Thomas A; Bertram, Melanie; Tollman, Stephen M; Hofman, Karen J
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
46.16%
Background: To determine whether training community health workers (CHWs) about hypertension in order to improve adherence to medications is a cost-effective intervention among community members in South Africa. Methods: We used an established Markov model with age-varying probabilities of cardiovascular disease (CVD) events to assess the benefits and costs of using CHW home visits to increase hypertension adherence for individuals with hypertension and aged 25–74 in South Africa. Subjects considered for CHW intervention were those with a previous diagnosis of hypertension and on medications but who had not achieved control of their blood pressure. We report our results in incremental cost-effectiveness ratios (ICERs) in US dollars per disability-adjusted life-year (DALY) averted. Results: The annual cost of the CHW intervention is about $8 per patient. This would lead to over a 2% reduction in CVD events over a life-time and decrease DALY burden. Due to reductions in non-fatal CVD events, lifetime costs are only $6.56 per patient. The CHW intervention leads to an incremental cost-effectiveness ratio of $320/DALY averted. At an annual cost of $6.50 or if the blood pressure reduction is 5 mmHg or greater per patient the intervention is cost-saving. Conclusions: Additional training for CHWs on hypertension management could be a cost-effective strategy for CVD in South Africa and a very good purchase according to World Health Organization (WHO) standards. The intervention could also lead to reduced visits at the health centres freeing up more time for new patients or reducing the burden of an overworked staff at many facilities.

Vulnerability of Bangladesh to Cyclones in a Changing Climate : Potential Damages and Adaptation Cost

Dasgupta, Susmita; Huq, Mainul; Khan, Zahirul Huq; Ahmed, Manjur Murshed Zahid; Mukherjee, Nandan; Khan, Malik Fida; Pandey, Kiran
Fonte: Banco Mundial Publicador: Banco Mundial
Relevância na Pesquisa
46.24%
This paper integrates information on climate change, hydrodynamic models, and geographic overlays to assess the vulnerability of coastal areas in Bangladesh to larger storm surges and sea-level rise by 2050. The approach identifies polders (diked areas), coastal populations, settlements, infrastructure, and economic activity at risk of inundation, and estimates the cost of damage versus the cost of several adaptation measures. A 27-centimeter sea-level rise and 10 percent intensification of wind speed from global warming suggests the vulnerable zone increases in size by 69 percent given a +3-meter inundation depth and by 14 percent given a +1-meter inundation depth. At present, Bangladesh has 123 polders, an early warning and evacuation system, and more than 2,400 emergency shelters to protect coastal inhabitants from tidal waves and storm surges. However, in a changing climate, it is estimated that 59 of the 123 polders would be overtopped during storm surges and another 5,500 cyclone shelters (each with the capacity of 1...

Cost-Effectiveness Measurement in Development : Accounting for Local Costs and Noisy Impacts

Evans, David K.; Popova, Anna
Fonte: World Bank Group, Washington, DC Publicador: World Bank Group, Washington, DC
EN_US
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46.06%
As evidence from rigorous impact evaluations grows in development, there have been more calls to complement impact evaluation analysis with cost analysis, so that policy makers can make investment decisions based on costs as well as impacts. This paper discusses important considerations for implementing cost-effectiveness analysis in the policy making process. The analysis is applied in the context of education interventions, although the findings generalize to other areas. First, the paper demonstrates a systematic method for characterizing the sensitivity of impact estimates. Second, the concept of context-specificity is applied to cost measurement: program costs vary greatly across contexts -- both within and across countries -- and with program complexity. The paper shows how adapting a single cost ingredient across settings dramatically shifts cost-effectiveness measures. Third, the paper provides evidence that interventions with fewer beneficiaries tend to have higher per-beneficiary costs, resulting in potential cost overestimates when extrapolating to large-scale applications. At the same time...

Deriving the Cost of Software Maintenance for Software Intensive Systems

Bradley J. Sams
Fonte: Escola de Pós-Graduação Naval Publicador: Escola de Pós-Graduação Naval
Tipo: Relatório
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46.21%
Sponsored Report (for Acquisition Research Program); Throughout software's lifetime, changes are introduced to the code in order to maintain the desired performance. These changes often create side effects, which cause other cascading effects elsewhere in the software or other system components with which the software interfaces. In a sense, the software degrades because of the maintenance performed on it, not because of a lack of maintenance upkeep. This pattern makes the cost of software maintenance difficult to predict, given the amount of variability in the upkeep process. Therefore, the best that program managers can hope for are heuristics that permit them to approximate annual operating budgets when calculating total ownership costs. Typically, these methods employ metrics used during development to estimate the annual cost of maintaining the software (i.e., source lines of code or function points). Through correlation and regression analysis, this thesis examines 62 programs that captured software maintenance data to determine a cost model for software maintenance. Even though a model was not built, the main contribution of this thesis is to provide a greater awareness of the complexity of estimating the costs for software maintenance. Additionally...

Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor

van Baaren, G.J.; Vis, J.; Grobman, W.; Bossuyt, P.; Opmeer, B.; Mol, B.
Fonte: Mosby Publicador: Mosby
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
46%
OBJECTIVE: The objective of the study was to evaluate the cost-effectiveness of risk stratification with cervical length (CL) measurement and/or fetal fibronectin (fFN) tests in women with threatened preterm labor between 24 and 34 weeks' gestation. STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate 7 test-treatment strategies in women with threatened preterm labor from a health care system perspective. Estimates on disease prevalence, costs, and test accuracy were based on medical literature. RESULTS: We found that additional fFN testing in the case of a CL between 10 and 30 mm is cost saving without compromising neonatal health outcomes, compared with a treat-all strategy or single CL testing. Implementing this strategy could lead to an annual cost saving between €2.8 million and €14.4 million in The Netherlands, a country with about 180,000 deliveries annually. CONCLUSION: In women with threatened preterm labor between 24 and 34 weeks of gestation, the most cost-effective test strategy uses a combination of CL and fFN testing.; Gert-Jan van Baaren, Jolande Y. Vis, William A. Grobman, Patrick M. Bossuyt, Brent C. Opmeer, Ben W. Mol

Institutional and familial cost of patients in continuous ambulatory peritoneal dialysis

Villarreal-Ríos,Enrique; Cárdenas-Maldonado,Cecilia; Vargas-Daza,Emma Rosa; Galicia-Rodríguez,Liliana; Martínez-González,Lidia; Baca-Baca,Roberto
Fonte: Associação Médica Brasileira Publicador: Associação Médica Brasileira
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
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46.28%
Objective: to determine the cost of institutional and familial care for patients with chronic kidney disease replacement therapy with continuous ambulatory peritoneal dialysis. Methods: a study of the cost of care for patients with chronic kidney disease treated with continuous ambulatory peritoneal dialysis was undertaken. The sample size (151) was calculated with the formula of the averages for an infinite population. The institutional cost included the cost of outpatient consultation, emergencies, hospitalization, ambulance, pharmacy, medication, laboratory, x-rays and application of erythropoietin. The family cost included transportation cost for services, cost of food during care, as well as the cost of medication and treatment materials acquired by the family for home care. The analysis included averages, percentages and confidence intervals. Results: the average annual institutional cost is US$ 11,004.3. The average annual family cost is US$ 2,831.04. The average annual cost of patient care in continuous ambulatory peritoneal dialysis including institutional and family cost is US$ 13,835.35. Conclusion: the cost of chronic kidney disease requires a large amount of economic resources, and is becoming a serious problem for health services and families. It's also true that the form of patient management in continuous ambulatory peritoneal dialysis is the most efficient in the use of institutional resources and family.

A Cost Impact Analysis of the Renewable Energy and Energy Efficiency Portfolio Standard for Investor-Owned Utilities in North Carolina

Lei, Ting
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Masters' project
Publicado em 26/04/2011 EN_US
Relevância na Pesquisa
46.02%
A Renewable Portfolio Standard (RPS) is a policy tool that sets a requirement for retail sellers of electricity to provide a minimum portion of their electricity sales from renewable resources. The RPS at state levels has become one of the most important policy incentives for stimulating clean energy expansion in electricity utilities in the United States. In 2007, North Carolina promulgated a Renewable Energy and Energy Efficiency Portfolio Standard (REPS), requiring the investor-owned utilities (IOUs) to meet up to 12.5% of their energy needs through renewable energy resources by 2021. This Master’s Project is designed to evaluate the cost and rate impacts of REPS on three IOUs in North Carolina from the perspective of retail market. Referring to the core modeling approaches and assumptions in the former technical report for North Carolina, this project establishes a cost impact model to compare the total annual cost of the Utilities’ Portfolio and Alternative REPS Portfolio from 2011 to 2030. The project also analyzes the impacts of different sensitivities. The results suggest that the REPS policy exerts no cost impact on IOUs until 2017 and a 0.54 cents/kWh increase of retail electricity rate will be reached in 2030 under the REPS obligation. According to sensitivity analysis...

Nuclear Reprocessing in the United States: A Levelized Cost Analysis

Grubert, Denise
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Masters' project Formato: 688101 bytes; application/pdf
EN_US
Relevância na Pesquisa
46%
Although most national policies require the long term storage of spent nuclear fuel, no geologic repository currently exists for this purpose. The United States government assumed the task of finding appropriate storage options for spent nuclear fuel more than twenty years ago. Billions of dollars have been invested into creating the federal repository at Yucca Mountain, yet it currently remains unclear if the facility will ever open. Some nations have begun reprocessing spent fuel inventories as a way to manage waste streams and secure energy supply. Considerable effort has been devoted toward the development of advanced reprocessing technologies that can reduce the volume of radioactive materials needing storage, while also generating electricity. Investment in deployment of such technologies will only be possible if the costs and risks associated with reprocessing can compete with alternative options. In order to analyze the economics of reprocessing spent nuclear fuel, the Cost of Electricity (COE) of this and other competing technologies was calculated. This evaluation allowed the identification of conditions that make reprocessing technologies competitive under different assumptions regarding uranium price, spent fuel storage cost...

The Direct Cost of Managing Patients With Chronic Hepatitis B Infection in Australia

Butler, James; Pianko, Stephen; Korda, Rosemary; Nguyen, Shara; Gow, Paul; Roberts, Stuart K; Strasser, Simone; Sievert, William
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
46.16%
GOALS: To estimate the average annual cost of managing a patient with chronic hepatitis B (CHB) disease in Australia. BACKGROUND: Little is known about the prevalence or economic burden of hepatitis B viral (HBV) infection in Australia, despite it being recognized as a significant cause of morbidity and mortality. STUDY: A retrospective analysis of 149 patients with CHB disease in six disease states (noncirrhotic CHB, compensated and decompensated cirrhosis, hepatocellular carcinoma, liver transplantation in year 1, and liver transplantation in subsequent posttransplantation years) was conducted. The cost of palliative care for 53 patients with chronic hepatitis and hepatocellular carcinoma was also estimated, based on data from a palliative care unit. RESULTS: The average annual costs (year-2001 AUS$) for each disease state per patient were: noncirrhotic CHB, 1233 dollars (95% CI 939 dollars-1544 dollars); compensated cirrhosis, 1394 dollars (95% CI 975 dollars-1797 dollars); decompensated cirrhosis, 11,961 dollars (95% CI 6993 dollars-18,503 dollars); liver transplantation in year 1, 144,392 dollars (SD, 115,374 dollars); liver transplantation in year 2+, 23,160 dollars (SD, 19,289 dollars); and hepatocellular carcinoma, 11,753 dollars (95% CI 7385 dollars-17...

Estimating the cost of treating patients with liver cirrhosis at the Mexican Social Security Institute

Quiroz,María Esther; Flores,Yvonne N; Aracena,Belkis; Granados-García,Víctor; Salmerón,Jorge; Pérez,Ruth; Cabrera,Guillermo; Bastani,Roshan
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2010 EN
Relevância na Pesquisa
46.22%
OBJECTIVE. To estimate the annual cost of treating patients with cirrhosis at the Mexican Institute of Social Security (IMSS per its abbreviation in Spanish). MATERIAL AND METHODS. The annual cost of treating three stages of cirrhosis (Child-Pugh A, Child-Pugh B and Child-Pugh C) was estimated using micro-costing techniques and medical experts. These results were compared and contrasted with prices reported by IMSS. RESULTS. The annual cost of treatment, in USA dollars, by Child-Pugh stage was: a) micro-costing results: $1110.17 stage A, $549.55 stage B and $348.16 stage C; b) opinion of medical experts: $1 633.64, $6564.04 and $19660.35, respectively; and c) IMSS costs: $4269.00, $16949.63 and $30249.25, respectively. CONCLUSIONS. The cost of treating patients with cirrhosis is considerable, and costs increase as the disease worsens. Cost estimates vary depending on the source of information, and the methodology used. There are discrepancies between the procedures reported in medical records and treatment recommendations by IMSS liver experts.

Cost-of-illness study of type 2 diabetes mellitus in Colombia

González,Juan Camilo; Walker,John H.; Einarson,Thomas R.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2009 EN
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46.37%
OBJECTIVE: To determine the per patient and overall cost of illness of type 2 diabetes mellitus (T2DM) in Colombia from Ministry of Health and societal perspectives. METHODS: A published Markov transition model was adapted for Colombia, using the clinical expertise of a Colombian endocrinologist. Transition probabilities for the model were derived from an international literature review. A model was run for a time horizon of 42 years. Direct resources (drugs, laboratory, medical, hospital, other health care) were identified and cost was ascertained by using national price lists, international health care guidelines, and other Colombian studies or data from other countries. Indirect costs (work time lost) were calculated by using the human capital approach. Annual and lifetime direct and indirect costs, in 2007 U.S. dollars with a 5% discount rate, were determined on a per patient basis and projected to the overall Colombian population. Costs were clustered according to treatments and outcomes. RESULTS: The estimated annual cost was $2.7 billion from the societal perspective and $921 million from the Ministry of Health perspective. The annual direct cost per patient was $288, and the indirect cost was $559 (total = $847). This cost was distributed across disease outcomes as follows: diabetes treatment (drugs)...

Does the Integrated Management of Childhood Illness cost more than routine care? Results from the United Republic of Tanzania

Adam,Taghreed; Manzi,Fatuma; Schellenberg,Joanna Armstrong; Mgalula,Leslie; de Savigny,Don; Evans,David B.
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/2005 EN
Relevância na Pesquisa
46.01%
OBJECTIVE: The Integrated Management of Childhood Illness (IMCI) strategy is designed to address the five leading causes of childhood mortality, which together account for 70% of the 10 million deaths occurring among children worldwide annually. Although IMCI is associated with improved quality of care, which is a key determinant of better health outcomes, it has not yet been widely adopted, partly because it is assumed to be more expensive than routine care. Here we report the cost of IMCI compared with routine care in four districts in the United Republic of Tanzania. METHODS: Total district costs of child care were estimated from the societal perspective as the sum of child health-care costs incurred in a district at the household level, primary health-facility level and hospital level. We also included administrative and support costs incurred by national and district administrations. The incremental cost of IMCI is the difference in costs of child health-care between districts with and without IMCI, after standardization for population size. FINDINGS: The annual cost per child of caring for children less than five years old in districts with IMCI was US$ 11.19, 44% lower than the cost in the districts without IMCI (US$ 16.09). Much of the difference was due to higher rates of hospitalization of children less than 5 years old in the districts without IMCI. Not all of this difference can be attributed to IMCI but even when differences in hospitalization rates are excluded...

Estimating the cost of treating patients with liver cirrhosis at the Mexican Social Security Institute

Quiroz,María Esther; Flores,Yvonne N; Aracena,Belkis; Granados-García,Víctor; Salmerón,Jorge; Pérez,Ruth; Cabrera,Guillermo; Bastani,Roshan
Fonte: Instituto Nacional de Salud Pública Publicador: Instituto Nacional de Salud Pública
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2010 EN
Relevância na Pesquisa
46.22%
OBJECTIVE. To estimate the annual cost of treating patients with cirrhosis at the Mexican Institute of Social Security (IMSS per its abbreviation in Spanish). MATERIAL AND METHODS. The annual cost of treating three stages of cirrhosis (Child-Pugh A, Child-Pugh B and Child-Pugh C) was estimated using micro-costing techniques and medical experts. These results were compared and contrasted with prices reported by IMSS. RESULTS. The annual cost of treatment, in USA dollars, by Child-Pugh stage was: a) micro-costing results: $1110.17 stage A, $549.55 stage B and $348.16 stage C; b) opinion of medical experts: $1 633.64, $6564.04 and $19660.35, respectively; and c) IMSS costs: $4269.00, $16949.63 and $30249.25, respectively. CONCLUSIONS. The cost of treating patients with cirrhosis is considerable, and costs increase as the disease worsens. Cost estimates vary depending on the source of information, and the methodology used. There are discrepancies between the procedures reported in medical records and treatment recommendations by IMSS liver experts.

Estimated annual cost of arterial hypertension treatment in Brazil

Dib,Murilo W.; Riera,Rachel; Ferraz,Marcos B.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2010 EN
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56.19%
OBJECTIVES: To estimate the direct annual cost of systemic arterial hypertension (SAH) treatment in Brazil's public and private health care systems, assess its economic impact on the total health care budget, and determine its proportion of the 2005 gross domestic product (GDP). METHODS: A decision tree model was used to determine direct costs based on estimated use of various resources in SAH diagnosis and care, including treatment (medication and non-medication), complementary exams, doctor visits, nutritional assessments, and emergency room visits. RESULTS: Estimated direct annual cost of SAH treatment was approximately US$ 398.9 million for the public health care system and US$ 272.7 million for the private system, representing 0.08% of the 2005 GDP (ranging from 0.05% to 0.16%). With total health care expenses comprising about 7.6% of Brazil's GDP, this cost represented 1.11% of overall health care costs (0.62% to 2.06%)-1.43% of total expenses for the Unified Healthcare System (Sistema Único de Saúde, SUS) (0.79% to 2.75%) and 0.83% of expenses for the private health care system (0.47% to 1.48%). Conclusion. To guarantee public or private health care based on the principles of universality and equality, with limited available resources...

Cyclosporine versus tacrolimus: cost-effectiveness analysis for renal transplantation in Brazil

Guerra Júnior,Augusto Afonso; Silva,Grazielle Dias; Andrade,Eli Iola Gurgel; Cherchiglia,Mariângela Leal; Costa,Juliana de Oliveira; Almeida,Alessandra Maciel; Acurcio,Francisco de Assis
Fonte: Faculdade de Saúde Pública da Universidade de São Paulo Publicador: Faculdade de Saúde Pública da Universidade de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
Relevância na Pesquisa
46.14%
OBJECTIVE To analyze the cost-effectiveness of treatment regimens with cyclosporine or tacrolimus, five years after renal transplantation.METHODS This cost-effectiveness analysis was based on historical cohort data obtained between 2000 and 2004 and involved 2,022 patients treated with cyclosporine or tacrolimus, matched 1:1 for gender, age, and type and year of transplantation. Graft survival and the direct costs of medical care obtained from the National Health System (SUS) databases were used as outcome results.RESULTS Most of the patients were women, with a mean age of 36.6 years. The most frequent diagnosis of chronic renal failure was glomerulonephritis/nephritis (27.7%). In five years, the tacrolimus group had an average life expectancy gain of 3.96 years at an annual cost of R$78,360.57 compared with the cyclosporine group with a gain of 4.05 years and an annual cost of R$61,350.44.CONCLUSIONS After matching, the study indicated better survival of patients treated with regimens using tacrolimus. However, regimens containing cyclosporine were more cost-effective.

The cost of diabetes in Latin America and the Caribbean

Barceló,Alberto; Aedo,Cristian; Rajpathak,Swapnil; Robles,Sylvia
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 EN
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46.04%
OBJETIVE: To measure the economic burden associated with diabetes mellitus in Latin America and the Caribbean. METHODS: Prevalence estimates of diabetes for the year 2000 were used to calculated direct and indirect costs of diabetes mellitus. Direct costs included costs due to drugs, hospitalizations, consultations and management of complications. The human capital approach was used to calculate indirect costs and included calculations of forgone earnings due to premature mortality and disability attributed to diabetes mellitus. Mortality and disability attributed to causes other than diabetes were subtracted from estimates to consider only the excess burden due to diabetes. A 3% discount rate was used to convert future earnings to current value. FINDINGS: The annual number of deaths in 2000 caused by diabetes mellitus was estimated at 339 035. This represented a loss of 757 096 discounted years of productive life among persons younger than 65 years (US$ 3 billion). Permanent disability caused a loss of 12 699 087 years and over US$ 50 billion, and temporary disability caused a loss of 136 701 years in the working population and over US$ 763 million. Costs associated with insulin and oral medications were US$ 4720 million, hospitalizations US$ 1012 million...