Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo最新文献

{"title":"Health care costs during the first 20 years of life in infants with hypoxic-ischemic encephalopathy in Brazil: estimated economic benefits generated by the use of therapeutic hypothermia and brain monitoring","authors":"G. Variane, Alexandre Netto, D. Rodrigues, Danieli Mayumi Kimura Leandro, Carolina Nunes de França, N. Llaguno, Maurício Magalhães, R. Pietrobom, Teresa Maria Lopes de Oliveira Uras Belém, M. J. Mimica","doi":"10.26432/1809-3019.2024.69.003","DOIUrl":"https://doi.org/10.26432/1809-3019.2024.69.003","url":null,"abstract":"Abstract\u0000Background: Hypoxic-ischaemic encephalopathy (HIE) is a leading cause of long-term disability. Infants with HIE may require specific lifelong care, representing a devastating social and economic impact. Therapeutic hypothermia (TH) has been proven to be a safe and effective treatment; however, its potential economic impact associated with continuous electroencephalographic monitoring is still unknown in Brazil. This study aimed to evaluate the potential economic benefits provided by TH and continuous electroencephalographic monitoring in the first 20 years of life in infants with HIE in Brazil. Methods: A resource utilization questionnaire about healthcare of infants with HIE was answered by 57 pediatricians and neonatologists in all five regions of Brazil. This data was used to calculate an annual weighted average of patient management costs according to the presence or degree of disability, considering only directly related health costs. A mathematical calculation was performed considering local incidence of HIE and the number of live births per year. Rates of death and survival for different levels of disability and the effect of TH on these outcomes were estimated from the two most relevant randomized controlled trials on TH. Results: There was an approximately 26-fold increase in spending when the severe disability group was compared to the no disability group (p-value<0.0001, ANOVA-Bonferroni). The estimated total cost of patients with no disability, mild, moderate, and severe disability is US$ 6,808.53, US$ 32,208.43, US$ 105,791.78 and US$ 175,698.58, respectively, and the estimated costs related to the use of TH and neuromonitoring were estimated in US$ 2,824.00. Considering a weighted average between TOBY trial and NICHD trial, it is estimated annual savings of US$ 39,700,000-79,401,000. Conclusions: This study estimated a significant increase in the costs associated with the degree of disability and a positive impact of TH throughout the first 20 years of life.  \u0000Keywords: Children with disability, Health care costs, Hypoxic-ischemic encephalopathy, Neonatal intensive care, Therapeutic hypothermia\u0000Resumo\u0000Introdução: A encefalopatia hipóxico-isquêmica (EHI) é uma das principais causas de deficiência incapacitante a longo prazo. Recém-nascidos (RN) com EHI podem necessitar de cuidados específicos ao longo da vida, representando um impacto social e econômico devastador. A hipotermia terapêutica (HT) é comprovadamente um tratamento seguro e eficaz; entretanto, seu potencial impacto econômico associado ao monitoramento eletroencefalográfico contínuo ainda é desconhecido no Brasil. Este estudo tem como objetivo avaliar os potenciais benefícios econômicos proporcionados pela HT e pela monitorização eletroencefalográfica contínua nos primeiros 20 anos de vida em lactentes com EHI no Brasil. Métodos: Um questionário de utilização de recursos sobre cuidados de saúde de crianças com EHI foi respondido por 57 pediatras e neonatologistas d","PeriodicalId":512675,"journal":{"name":"Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo","volume":"35 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}