Primary Care in Supplementary Health: impact on care costs of elderly patients with heart disease

Abstract

Introduction: Population aging has been changing the epidemiological profile in the World. Cardiovascular diseases are the leading cause of death in many countries and have an impact on health spending. Objectives: To identify factors that influence health care costs in elderly patients with heart disease treated at a Supplementary Primary Health Care (PHC) unit in Brazil. Methods: Retrospective cohort of 223 patients with heart disease aged ≥ 60 years from one year before and one year after PHC implantation. Data were obtained from electronic medical records and the costs in the total cost of care database (hospital, outpatient and home). Patients were classified according to the Clinical-Functional Vulnerability Index (CFVI-20). Results: There was no reduction in total costs, but it occurred in hospitalization expenses after the implementation of PHC for the whole sample (mean ± SD, US$ 698.43 ± US$ 3,500.76, p=0.011), with a significant reduction among (p=0.023), pre-diagnosis of acute myocardial infarction (AMI) (p=0.023), eutrophic BMI (p=0.027), non-smokers (p=0.020), and robust according to the CFVI-20 (p=0.013). There was a decrease in the frequency of hospitalization for the whole sample (p=0.006), among males (p=0.014), age between 71 and 80 years (p=0.001), robust (p=0.025) and AMI (p= 0.027). There was a reduction in the frequency of consultations in the Emergency Department among fragile elderly (p=0.011). Conclusions: There was a reduction in the frequency and cost of hospitalization in elderly patients with heart disease in follow-up at PHC, in addition to reducing the frequency of consultation in PHC in the fragile elderly.