Cost-benefit of hospitalization compared with outpatient care for pregnant women with pregestational and gestational diabetes or with mild hyperglycemia, in Brazil

Sao Paulo Medical Journal

Ana Claudia Molina Cavassini¹  Silvana Andréa Molina Lima²  Iracema Mattos Paranhos Calderon²  Marilza Vieira Cunha Rudge² 

[1],Universidade Estadual Paulista Faculdade de Medicina de Botucatu Botucatu São Paulo ,Brazil

关键词: Hospital costs;    Gestational diabetes;    Cost-benefit analysis;    Health care costs;    Costs and cost analysis;    Custos hospitalares;    Diabetes gestacional;    Análise custo-benefício;    Custos de cuidados de saúde;    Custos e análise de custo;   

DOI  :  10.1590/S1516-31802012000100004

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Pregnancies complicated by diabetes are associated with increased numbers of maternal and neonatal complications. Hospital costs increase according to the type of care provided. This study aimed to estimate the cost-benefit relationship and social profitability ratio of hospitalization, compared with outpatient care, for pregnant women with diabetes or mild hyperglycemia. STUDY DESIGN: This was a prospective observational quantitative study conducted at a university hospital. It included all pregnant women with pregestational or gestational diabetes, or mild hyperglycemia, who did not develop clinical intercurrences during pregnancy and who delivered at the Botucatu Medical School Hospital (Hospital das Clínicas, Faculdade de Medicina de Botucatu, HC-FMB) of Universidade Estadual de São Paulo (Unesp). METHODS: Thirty pregnant women treated with diet were followed as outpatients, and twenty treated with diet plus insulin were managed through frequent short hospitalizations. Direct costs (personnel, materials and tests) and indirect costs (general expenses) were ascertained from data in the patients' records and the hospital's absorption costing system. The cost-benefit was then calculated. RESULTS: Successful treatment of pregnant women with diabetes avoided expenditure of US$ 1,517.97 and US$ 1,127.43 for patients treated with inpatient and outpatient care, respectively. The cost-benefit of inpatient care was US$ 143,719.16, and outpatient care, US$ 253,267.22, with social profitability of 1.87 and 5.35, respectively. CONCLUSION: Decision-tree analysis confirmed that successful treatment avoided costs at the hospital. Cost-benefit analysis showed that outpatient management was economically more advantageous than hospitalization. The social profitability of both treatments was greater than one, thus demonstrating that both types of care for diabetic pregnant women had positive benefits.

【 授权许可】

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