Custos com os prestadores de serviço na atenção a Doença Renal Crônica em meio aos caminhos e descaminhos do SUS

Abstract

The hypothesis of this thesis is that predialysis monitoring services are cost-minimization in relation to the services provided in dialysis therapy (DT), observing the SUS perspective in the payment to service providers. Thus, the objective of the research is to present results of a cost study with predialysis service providers in relation to dialysis therapy services in order to provide information on the financial impact of effect Cost-Minimizer to the public budget. For this, we present two articles that fulfill the research to understand the outcomes of the financing of dialysis therapy and its budgetary dilemmas due to the restriction of SUS costs in the maintenance of therapeutic services and another that presents the results of the evolution of costs in the stages of chronic kidney disease and the risks of rising costs with the admission of patients in dialysis therapy. The results point to a situation of cost restriction to dialytic therapy in the order of $192.3 million (± $18.7 million) per year as reflections of a policy to the rebalancing of public accounts and recently associated in a plan of Fiscal Austerity. Predialysis showed a minimization effect of the public budget that can generate a mean reduction of $8,501.47 (± $431.68) per patient for each year avoided in DT. As a conclusion, it is possible that the predialysis values without any effect of discount, in addition to the clinical gains and the quality of life of the patients, may contribute to the potential impact of cost-minimizer effects on DT. The results also suggest that screening and sensitization actions of patients with CKD reduce the risks with higher DT costs.