An exploratory study of the costs and consequences of prenatal care in the Family Health Program

• Autor(a) principal: Vidal, Suely Arruda
• Data de Publicação: 2011
• Outros Autores: Samico, Isabella Chagas, Frias, Paulo Germano de, Hartz, Zulmira Maria de Araújo
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Revista de Saúde Pública
• Texto Completo: https://www.revistas.usp.br/rsp/article/view/32978
• topic: Avaliação de Custo-Efetividade; Cuidado Pré-Natal; Programa Saúde da Família; Estudos de Avaliação como Assunto; Avaliación de Costo-Efectividad; Atención Prenatal; Programa de Salud Familiar; Estudios de Evaluación como Asunto; Cost-Effectiveness Evaluation; Prenatal Care; Family Health Program; Evaluation Studies as Topic

OBJECTIVE: To assess costs and consequences of prenatal care on perinatal morbidity and mortality. METHODS: Evaluation study using two types of analysis: implementation and efficiency analysis, carried out at 11 Family Health Units in the Recife, Northeastern Brazil, in 2006. The costs were calculated by means of the activity-based costing technique and the cost-effectiveness ratio was calculated for each consequence. Data sources were information systems of the Ministry of Health and worksheets of costs provided by the Health Department of Recife and Instituto de Medicina Integral Prof. Fernando Figueira. Healthcare units with implemented or partially implemented prenatal care were compared in terms of their cost-effectiveness and perinatal results. RESULTS: In 64% of the units, prenatal care was implemented with a mean total cost of R$ 39,226.88 and variation of R$ 3,841,87 to R$ 8,765.02 per healthcare unit. In the units with partially implemented prenatal care (36%), the mean total cost was R$ 30,092.61 (R$ 4,272.12 to R$ 11,774.68). The mean cost per pregnant woman was R$ 196.13 with implemented prenatal care and R$ 150.46 with partially implemented prenatal care. A higher proportion of low birth weight, congenital syphilis, perinatal and fetal deaths was found in the partially implemented group. CONCLUSIONS: Prenatal care is cost-effective for several studied consequences. The adverse effects measured by the health indicators were lower in the units with implemented prenatal care. The mean cost in the partially implemented group was higher, which suggests a possible waste of resources, as the teams' productivity is insufficient for the installed capacity.