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

Detalhes bibliográficos
Autor(a) principal: Zara, Ana Laura de Sene Amâncio
Data de Publicação: 2016
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UFG
dARK ID: ark:/38995/0013000000sbq
Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/7727
Resumo: 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.
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spelling Toscano, Cristiana Mariahttp://lattes.cnpq.br/3772312631884265Siqueira Júnior, João BoscoToscano, Cristiana MariaOliveira, Ellen Synthia FernandesCoelho, Giovanini EvelimMartelli, Celina Maria TurchiTurchi, Marília Dalvahttp://lattes.cnpq.br/8039224852182884Zara, Ana Laura de Sene Amâncio2017-09-15T15:06:03Z2016-08-02ZARA, A. L. S. A. Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil. 2016. 172 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2016.http://repositorio.bc.ufg.br/tede/handle/tede/7727ark:/38995/0013000000sbqIntroduction: 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.Introdução: estimativas de custos da dengue são importantes para subsidiar avaliações econômicas completas e úteis para tomada de decisões quanto à incorporação de novas tecnologias, como vacinas e estratégias alternativas de controle do Aedes. Objetivos: estimar a utilização de serviços de saúde (USS) pelos pacientes ambulatoriais e hospitalizados, nos setores público e privado, e por gravidade da doença, em 2012-2013; identificar possíveis fontes de dados e metodologias para estimativas de custos da dengue no Brasil, considerando fontes primárias e secundárias de dados; e estimar os custos totais da dengue no Brasil, em 2013-2014, considerando custos da doença e custos do programa de controle. Métodos: para USS foi realizado um estudo multicêntrico em seis capitais brasileiras, a partir de questionários e prontuários médicos. Para o custeio da doença e do programa de controle foram utilizadas variadas fontes de informação, a partir de métodos de microcusteio e macrocusteio conforme disponibilidade dos dados. Resultados: para o estudo de USS participaram 2.035 pacientes, dos quais, 1.167 (57,3%) eram do sexo feminino, 1.657 (81,4%) eram pacientes ambulatoriais, 378 (18,6%) foram hospitalizados, 1.361 (66,9%) pacientes eram do setor público, e 398 (19,6%) eram crianças (≤ 14 anos). No setor público, os pacientes realizaram, em média, 1,9 consulta, e os pacientes hospitalizados receberam, em média 4,5 visitas médicas. No setor privado, os pacientes realizaram, em média, 2,2 consultas, e os pacientes hospitalizados receberam, em média 5,1 visitas médicas. A grande maioria dos pacientes hospitalizados teve hemograma completo, contagem de plaquetas e hematócrito realizados e recebeu antipirético/analgésico, em ambos os setores público e privado. Em 2013-2014, o custo do programa de controle da dengue foi de US$1,2 bilhão, sendo 23% correspondente aos custos federais e 77% aos custos municipais. Os custos da doença variaram de acordo com as fontes de informação. Se utilizadas as fontes primárias, os custos diretos médicos chegaram a US$1,2 bilhão, e por fontes secundárias (USS), os custos foram de US$330,2 milhões. Os custos indiretos chegaram a US$5,2 milhões considerando as fontes primárias. Conclusão: os padrões de USS variaram significativamente de acordo com o setor de saúde e com a gravidade da doença. Em geral, o padrão de USS está em conformidade com as orientações do MS. Em 2013-2014, o custo total da dengue variou entre US$ 1,53 bilhão e US$ 1,69 bilhão. Se ajustado o número de casos subnotificados, os custos variam de US$6,86 bilhões a US$7,78 bilhões. A dengue impõe custos substanciais para a saúde e a economia no Brasil. Espera-se que esses resultados possam contribuir para o planejamento econômico e assistencial imprescindíveis para a sustentabilidade do programa de controle da dengue no Brasil, que, em geral, tem seus custos subestimados.Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2017-09-05T16:25:22Z No. of bitstreams: 2 Tese - Ana Laura de Sene Amâncio Zara - 2017.pdf: 3959463 bytes, checksum: 51394e12c85247544283c6fdfd6f2bf6 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-09-15T15:06:02Z (GMT) No. of bitstreams: 2 Tese - Ana Laura de Sene Amâncio Zara - 2017.pdf: 3959463 bytes, checksum: 51394e12c85247544283c6fdfd6f2bf6 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2017-09-15T15:06:03Z (GMT). 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dc.title.eng.fl_str_mv Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
dc.title.alternative.eng.fl_str_mv Estimate of health services utilization and costs associated with dengue in Brazil
title Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
spellingShingle Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
Zara, Ana Laura de Sene Amâncio
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
title_short Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
title_full Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
title_fullStr Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
title_full_unstemmed Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
title_sort Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil
author Zara, Ana Laura de Sene Amâncio
author_facet Zara, Ana Laura de Sene Amâncio
author_role author
dc.contributor.advisor1.fl_str_mv Toscano, Cristiana Maria
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/3772312631884265
dc.contributor.advisor-co1.fl_str_mv Siqueira Júnior, João Bosco
dc.contributor.referee1.fl_str_mv Toscano, Cristiana Maria
dc.contributor.referee2.fl_str_mv Oliveira, Ellen Synthia Fernandes
dc.contributor.referee3.fl_str_mv Coelho, Giovanini Evelim
dc.contributor.referee4.fl_str_mv Martelli, Celina Maria Turchi
dc.contributor.referee5.fl_str_mv Turchi, Marília Dalva
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/8039224852182884
dc.contributor.author.fl_str_mv Zara, Ana Laura de Sene Amâncio
contributor_str_mv Toscano, Cristiana Maria
Siqueira Júnior, João Bosco
Toscano, Cristiana Maria
Oliveira, Ellen Synthia Fernandes
Coelho, Giovanini Evelim
Martelli, Celina Maria Turchi
Turchi, Marília Dalva
dc.subject.por.fl_str_mv Dengue
Utilização de serviços de saúde
Custo da doença
Custos e análise de custos
Avaliação econômica
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
dc.subject.eng.fl_str_mv Health service utilization
Cost of Illness
Costs and cost analysis
Economic evaluation
dc.subject.cnpq.fl_str_mv SAUDE COLETIVA::SAUDE PUBLICA
description 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.
publishDate 2016
dc.date.issued.fl_str_mv 2016-08-02
dc.date.accessioned.fl_str_mv 2017-09-15T15:06:03Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
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dc.identifier.citation.fl_str_mv ZARA, A. L. S. A. Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil. 2016. 172 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2016.
dc.identifier.uri.fl_str_mv http://repositorio.bc.ufg.br/tede/handle/tede/7727
dc.identifier.dark.fl_str_mv ark:/38995/0013000000sbq
identifier_str_mv ZARA, A. L. S. A. Estimativa de utilização de serviços de saúde e de custos associados à dengue no Brasil. 2016. 172 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2016.
ark:/38995/0013000000sbq
url http://repositorio.bc.ufg.br/tede/handle/tede/7727
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publisher.none.fl_str_mv Universidade Federal de Goiás
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