Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil

• Main Author: Zara, Ana Laura de Sene Amâncio
• Publication Date: 2016
• Format: Doctoral thesis
• Language: por
• Source: Repositório Institucional da UFG
• Download full: http://repositorio.bc.ufg.br/tede/handle/tede/7727
• topic: Dengue; Utilização de serviços de saúde; Custo da doença; Custos e análise de custos; Avaliação econômica; Health service utilization; Cost of Illness; Costs and cost analysis; Economic evaluation; SAUDE COLETIVA::SAUDE PUBLICA

Introduction: dengue cost estimates are important to support complete and useful economic evaluations for decision making regarding the incorporation of new technologies, such as vaccines and alternative strategies to control Aedes. Objectives: to estimate the health services utilization (HSU) for outpatients and hospitalized in the public and private sectors, and severity of the disease, in 2012-2013; identify possible sources of data and methodologies for dengue cost estimates in Brazil, considering primary and secondary sources of data; and estimate the total costs of dengue in Brazil, in 2013-2014, considering costs of the disease and control program costs. Methods: for HSU was conducted a multicenter study in six Brazilian capitals, from questionnaires and medical records. For the cost of illness (COI) and the cost of control program were used various sources of information, from microcusteio and macrocusteio methods as data availability. Results: for the HSU study attended 2,035 patients, of whom 1,167 (57.3%) were women, 1,657 (81.4%) were outpatients, 378 (18.6%) were hospitalized, 1,361 (66 9%) patients were in the public sector, and 398 (19.6%) were children (≤ 14 years). In the public sector, patients underwent an average of 1.9 visit, and hospital patients were on average 4.5 medical visits. In the private sector, the patients were, on average, 2.2 visits, and hospital patients were on average 5.1 medical visits. The vast majority of hospitalized patients had complete blood count, platelet count and hematocrit performed, received antipyretic/analgesic, in both public and private sectors. In 2013-2014, the cost of the dengue control program was US$1.2 billion, with 23% corresponding to federal costs and 77% to municipal costs. The costs of the disease varied according to the sources of information. If primary sources were used, direct medical costs amounted to US$1.2 billion, and from secondary sources (HSU), the costs were US$330.2 million. Indirect costs amounted to US$5.2 million, considering the primary sources. Conclusion: HSU patterns varied significantly according to the health sector and the severity of the disease. In general, the pattern of HUS complies with the guidelines of the MS. In 2013-2014, the total cost of dengue ranged from US$1.53 billion to US$1.69 billion. If the number of underreporting cases was adjusted, costs ranged from US$6.86 billion to US$7.78 billion. Dengue imposes substantial costs to the health and economy in Brazil. It is expected that these results can contribute to the economic and welfare planning essential for the sustainability of the dengue control program in Brazil, which generally has its costs underestimated.