Desempenho e gastos do SUS com revascularizações do miocárdio no Estado do Rio de Janeiro, de 1999 a 2008

Abstract

. In the analysis of decreasing mortality trends due to IHD, multiple factors must be considered, including age, sex, diagnosis, therapeutic interventions and environmental and socioeconomic conditions. The studies with data recorded from clinical practice provide a view that is closer to reality than the experimental ones 3 .In a study with samples of coronary angiography (CA) records performed in public hospitals in the city of Rio de Janeiro (CRJ), from 1999 to 2003, a mean in-hospital mortality of 1.6% was observed, ranging from 0.9 % to 6.8%. Mortality rates in primary and rescue CA were 17.4% and 13.1%, and in elective CA, it was 0.8% 4 . During the same period, in 2,692 coronary artery bypass graft (CABG) records in the CRJ, a variation between hospitals was observed, from 7.0% to 14.3% in the in-hospital period, and 8.5% to 20.2 % up to one year post-hospital release and a significant association between the occurrence of complications and postoperative death (p <0.0001) 5. Therefore, regarding myocardial revascularization procedures, the minimum required performance was not observed in the SRJ 6 , representing an important financial burden for the Brazilian Public Health System (SUS), with individual and social consequences 7 .In the middle of the last decade of the twentieth century, it was estimated that 80% of medical or hospital care was financed by the Public Health System (SUS) in Brazil