Análise de custo e efetividade do tratamento de diabéticos adultos atendidos no Centro Hiperdia de Juiz de Fora, Minas Gerais

Abstract

The economic burden of chronic disease produces high costs for health systems, and especially for society. Thus, the Ministry of Health has adopted strategies to reduce the burden of these diseases to the Brazilian population. In Minas Gerais, one of the strategies used was the implementation of "Hiperdia Mines Program," which has the purpose of structuring the health care network for patients with hypertension, diabetes mellitus and chronic kidney disease through regionalized and integrated system of services health. Face of rising costs and limited financial resources, the challenge for the allocation of resources is present in many health care settings. Considering the relevance of diabetes within the public health and the lack of studies that analyze the costs of this disease, especially the costs of secondary care, this study aimed to analyze the direct costs and effectiveness of treatment in diabetics treated at the Center Hiperdia of Juiz de Fora - MG from the perspective of the National Health System. This is a partial economic evaluation of the type and cost analysis of results. The direct costs of treatment of type 2 diabetes for drugs components, and additional laboratory tests, medical and nonmedical queries and also the self-monitoring of glycemia capillary for a minimum period of one year were measured. To calculate the cost, we adopted the values of appointments and tests of Table Unified Procedures SUS for drug treatment factory price of medicines Price Database Chamber of Drug Market Regulation of the National Surveillance Agency health, and self-monitoring for the price of Stock Prices in Health. Effectiveness was defined as the percentage of patients achieving the goal of treatment in accordance with the values of HbA1c for adults < 7 % and ≤ 8% for seniors. Of the 168 patients selected were predominantly female (65,9%) , married (55,3%) with incomplete primary level of education (64,1%), retired (31,5%) , skin color brown (37,6%) , the mean age was 60,04 ± 10,69 years. The average annual cost per patient was R$ 1.478,79, drug treatment being responsible for the higher cost (67,06%). There was no difference in the total cost in relation to sex, age, marital status and education. However, was associated significantly the number of comorbidities mode, this being greater the more comorbidities (p = 0,033). The effectiveness was achieved by 40,97% and 76,3% of those who had reached 60 years or older (p = 0,001). Studies at the national level can help to know the exact social and economic burden of disease and thereby contribute to the development of health policies for diabetic patients. Likewise, it is essential to strengthen health services for primary and secondary health care in order to reduce the impact of disease through better access to healthcare and the quality of the services.