Coronary Artery Bypass Graft Surgery Cost Coverage by the Brazilian Unified Health System (SUS)

Silva, Gilmara Silveira da; Colósimo, Flávia Cortez; Sousa, Alexandre Gonçalves de; Piotto, Raquel Ferrari; Castilho, Valéria

doi:10.21470/1678-9741-2016-0069

Cited by 15 publications

(16 citation statements)

References 16 publications

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“…In our country, Silva et al [16] showed an operative mortality rate of 4.0% in patients operated by the Unified Health System (SUS) at the Hospital Beneficência Portuguesa in São Paulo, while Fortes et al [16,17] showed an average mortality of 7.4% in patients referred for CABG in a university hospital in northeastern Brazil. TotalCor Hospital, a private hospital focused on cardiology, points to a mortality rate of 1.7%.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry

Paez¹,

Hossne²,

Santo³

et al. 2019

Braz J Cardiovasc Surg

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Introduction Coronary artery bypass grafting (CABG) is the most frequently performed heart surgery in Brazil. Recent international guidelines recommend that national societies establish a database on the practice and results of CABG. In anticipation of the recommendation, the BYPASS Registry was introduced in 2015. Objective To analyze the profile, risk factors and outcomes of patients undergoing CABG in Brazil, as well as to examine the predominant surgical strategy, based on the data included in the BYPASS Registry. Methods A cross-sectional study of 2292 patients undergoing CABG surgery and cataloged in the BYPASS Registry up to November 2018. Demographic data, clinical presentation, operative variables, and postoperative hospital outcomes were analyzed. Results Patients referred to CABG in Brazil are predominantly male (71%), with prior myocardial infarction in 41.1% of cases, diabetes in 42.5%, and ejection fraction lower than 40% in 9.7%. The Heart Team indicated surgery in 32.9% of the cases. Most of the patients underwent cardiopulmonary bypass (87%), and cardioplegia was the strategy of myocardial protection chosen in 95.2% of the cases. The left internal thoracic artery was used as a graft in 91% of the cases; the right internal thoracic artery, in 5.6%; and the radial artery in 1.1%. The saphenous vein graft was used in 84.1% of the patients, being the only graft employed in 7.7% of the patients. The median number of coronary vessels treated was 3. Operative mortality was 2.8%, and the incidence of cerebrovascular accident was 1.2%. Conclusion CABG data in Brazil provided by the BYPASS Registry analysis are representative of our national reality and practice. This database constitutes an important reference for indications and comparisons of therapeutic procedures, as well as to propose subsequent models to improve patient safety and the quality of surgical practice in the country.

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Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry

Paez¹,

Hossne²,

Santo³

et al. 2019

Braz J Cardiovasc Surg

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“…The average length of postoperative hospital stays after isolated primary elective CABG in one of the reference hospitals in our region is 8.5 days 22 . Therefore, this protocol would have the potential to rotate the bed almost 3 times faster.…”

Section: Discussionmentioning

confidence: 98%

Safe and effective protocol for discharge 3 days after cardiac surgery

Mejía

Borgomoni

Lasta

et al. 2021

Sci Rep

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The Enhanced Recovery After Surgery (ERAS) protocol affected traditional cardiac surgery processes and COVID-19 is expected to accelerate its scalability. The aim of this study was to assess the impact of an ERAS-based protocol on the length of hospital stay after cardiac surgery. From January 2019 to June 2020, 664 patients underwent consecutive cardiac surgery at a Latin American center. Here, 46 patients were prepared for a rapid recovery through a multidisciplinary institutional protocol based on the ERAS concept, the “TotalCor protocol”. After the propensity score matching, 46 patients from the entire population were adjusted for 12 variables. Patients operated on the TotalCor protocol had reduced intensive care unit time (P < 0.025), postoperative stay (P ≤ 0.001) and length of hospital stay (P ≤ 0.001). In addition, there were no significant differences in the occurrence of complications and death between the two groups. Of the 10-central metrics of TotalCor protocol, 6 had > 70% adherences. In conclusion, the TotalCor protocol was safe and effective for a 3-day discharge after cardiac surgery. Postoperative atrial fibrillation and renal failure were predictors of postoperative stay > 5 days.

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“…In Brazil, public hospitals are key institutions in the health system, consuming up to 70% of public expenses. Federal transfers have been decreasing every year, aggravating the financial crisis of health institutions related to SUS (5)(6) .…”

Section: Introductionmentioning

confidence: 99%

“…Cost management is indispensable for health institutions, especially for those which depend on transferences from SUS, since, when there is no control, services are agreed upon inefficiently. This management should be specific for each sector and a large share of the positive results should be reinvested in the institution itself, a consequence of the statements in many management actions dedicated to following, continuous review of established contracts, and resource maximization (5) .…”

Section: Introductionmentioning

confidence: 99%

Coverage for the cost of outpatient nursing procedures by the Unified Health System: a percentage analysis

Sportello

Castilho

Lima

2021

Rev. esc. enferm. USP

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Objective: To analyze the percentage of the coverage of transfers from the Brazilian Unified Health System regarding nursing procedures conducted in the Outpatient facility of a University Hospital. Method: Quantitative, exploratory, descriptive case study. The sample for calculating the mean total direct costs was composed of non-participant observations of 656 procedures. The obtained costs were compared to transfers from the Unified Health System by multiplying the amount of procedures agreed upon by the unit cost in the Unified Table of Procedures in 2016 and 2017. Results: The Unified Health System transferred a percentage corresponding to 11.13% of the actual cost in 2016 and to 16.02% in 2017. In these two years, transfer values covered only a mean of 13.4%, resulting in a percentage difference in revenue significantly smaller than the actual cost. Conclusion: The higher the productivity of the performed procedures, the higher was the hospital deficit and, consequently, the higher were the costs not covered by the Unified Health System.

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Coronary Artery Bypass Graft Surgery Cost Coverage by the Brazilian Unified Health System (SUS)

Cited by 15 publications

References 16 publications

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry

Coronary Artery Bypass Surgery in Brazil: Analysis of the National Reality Through the BYPASS Registry

Safe and effective protocol for discharge 3 days after cardiac surgery

Coverage for the cost of outpatient nursing procedures by the Unified Health System: a percentage analysis

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