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RESUMO - Introdução: A pré-eclâmpsia (PE) é uma complicação da gravidez que afeta cerca de 2-7% das mulheres no mundo, sendo uma das principais causas de mortalidade e morbilidade materna e perinatal. Nos países desenvolvidos anualmente são gastos cerca de € 31 biliões em custos diretos na prestação de cuidados de saúde para o tratamento da PE. Em comparação com a investigação na clínica, a literatura sob a avaliação de custos da PE é bastante limitada. Portanto, quem se debruça sobre esta matéria é unanime em considerar um elevado custo associado à PE.
Metodologia: Utiliza-se o sistema de classificação de doentes Disease Staging para calcular os custos, estadios de gravidade e readmissões. Os custos da PE na perspetiva de doença principal ou como comorbilidade foram calculados com base nos valores dos grupos de diagnósticos homogéneos da Portaria nº 20/2014 na perspetiva do pagador. Os estadios e as readmissões foram apuradas através do Disease Staging.
Resultados: Como doença principal, a PE apresenta 671 casos, maioritariamente (96%) no subestadio 1.01 de gravidade, uma prevalência média de 0,33% e um custo de 420 370,76 € para os três anos. Como comorbilidade, a PE apresenta 4187 casos, uma prevalência média de 2,09% e um custo de 985 263,91 € para os três anos. Existiram no total 304 readmissões dos 671 episódios de internamento. Do total de readmissões, 298 (98%) correspondem à causa de readmissão atribuída pelo Disease Staging relativo a complicações obstétricas.
Conclusão: Os valores apurados para o custo da PE como doença principal podem estar subestimados, devido à sua baixa prevalência. No entanto, a prevalência da PE como comorbilidade encontra-se dentro do limiar inferior estipulado na bibliografia e, consequentemente, os custos foram mais elevados.
ABSTRACT - Introduction: Preeclampsia (PE) is a pregnancy complication that affects nearly 2-7% of women worldwide, being one of the main causes of mortality and maternal and perinatal morbidity. In developed countries annually are spent about € 31 billion in direct costs in providing health care for the treatment of PE. Compared with clinical research, the literature review on PE cost is quite limited. So who focuses on the issue is unanimous in considering a high cost associated with the PE. Methodology: The Disease Staging patient classification system to calculate costs, stages of severity and readmissions is used. The PE costs from the perspective of primary disease or as comorbidity were calculated based on the values of homogenous diagnostic groups of Ordinance No. 20/2014 on the perspective of the payer. The stages and readmissions were cleared by Disease Staging Results: As the primary disease, PE presents 671 cases mainly (96%) in 1.01 substage of severity, an average prevalence of 0.33% and a cost of 420,370.76 € for three years. As comorbidity, PE presents 4187 cases, an average prevalence of 2.09% and a cost of 985,263.91 € for three years. There were in total 304 readmissions of 671 episodes of hospitalization. Of total readmissions, 298 (98%) correspond to the readmission cause assigned by Disease Staging concerning obstetric complications. Conclusion: The values calculated for the cost of PE as the primary disease may be underestimated due to its low prevalence. However, the prevalence of PE as comorbidity is within the lower limit stated in the literature and hence the costs were higher.
ABSTRACT - Introduction: Preeclampsia (PE) is a pregnancy complication that affects nearly 2-7% of women worldwide, being one of the main causes of mortality and maternal and perinatal morbidity. In developed countries annually are spent about € 31 billion in direct costs in providing health care for the treatment of PE. Compared with clinical research, the literature review on PE cost is quite limited. So who focuses on the issue is unanimous in considering a high cost associated with the PE. Methodology: The Disease Staging patient classification system to calculate costs, stages of severity and readmissions is used. The PE costs from the perspective of primary disease or as comorbidity were calculated based on the values of homogenous diagnostic groups of Ordinance No. 20/2014 on the perspective of the payer. The stages and readmissions were cleared by Disease Staging Results: As the primary disease, PE presents 671 cases mainly (96%) in 1.01 substage of severity, an average prevalence of 0.33% and a cost of 420,370.76 € for three years. As comorbidity, PE presents 4187 cases, an average prevalence of 2.09% and a cost of 985,263.91 € for three years. There were in total 304 readmissions of 671 episodes of hospitalization. Of total readmissions, 298 (98%) correspond to the readmission cause assigned by Disease Staging concerning obstetric complications. Conclusion: The values calculated for the cost of PE as the primary disease may be underestimated due to its low prevalence. However, the prevalence of PE as comorbidity is within the lower limit stated in the literature and hence the costs were higher.
Descrição
Trabalho Final do Curso de Especialização em Administração Hospitalar
Palavras-chave
Pré-eclâmpsia Custos Internamento Administração Hospitalar Preeclampsia Hospitalization Costs Hospital Management
Contexto Educativo
Citação
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública