Análise do custo do tratamento fisioterapêutico de pacientes sequelados por acidentes vasculares cerebrais pelo Sistema Único de Saúde na cidade de Juiz de Fora, MG

Abstract

Introduction: chronic degenerative diseases like cerebrovascular entity occupy a prominent position in relation to their morbidity and global mortality rates. The stroke falls within the list of such diseases and is characterized by blockage or rupture of a blood vessel in the brain, causing psychomotor impairment or even death. Advanced age, hypertension, diabetes and hypercholesterolemia are among the main factors of risk for the disease. Health economics provide new perspectives to understanding health, integrating elements of the economy as costs and the search for results in the health assessment processes. The main objective was to identify the total cost of treating these patients by the National Health System perspective. Material and methods: a cross-sectional survey, with evaluation of patients scheduled for physical therapy in Juiz de Fora City Secretariat. Components of the research, besides the clinical and epidemiological user profile description, were the total cost (direct and indirect costs) and the cost-utility of treatment. A questionnaire prepared by the author was applied to these patients, providing patient information, which was followed by a statistical analysis. Results: the total cost of treatment spent in the year 2014 was R$ 656,025.00, with an average of R$ 6,904.00 per patient, being composed of direct costs (11%) and indirect costs (89%). Integrating the direct costs, physical therapy accounted for half of the expenses (50%), followed by spending on medicines (26%), use of orthoses (8%), use of transporting support for treatment (7%), additional tests (5%) and medical consultation (4%). Indirect costs were composed of the disability retirement (53%) and benefits granted by INSS (47%). The cost-utility found for these patients was R$ R$ 13,052.93 per year. When assessing costs among categories statistical differences were found between the total costs when compared to the actual patient age and age at stroke, chronic disease, existence of own work at the time of the accident and the amount of money received (p <0.05). Conclusion: the total costs in the stroke patients treatment in Juiz de Fora city varied mainly due to indirect costs, with higher rates for younger patients, inserted for a longer time the rehabilitation service, economically active at the time of the stroke and greater income.