Resource utilization and cost of rheumatic fever

Resource utilization and cost of rheumatic fever

Author Terreri, Maria Teresa Autor UNIFESP Google Scholar
Ferraz, M. B. Google Scholar
Goldenberg, J. Google Scholar
Len, Claudio Arnaldo Autor UNIFESP Google Scholar
Hilário, Maria Odete Esteves Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective. The socioeconomic effects of rheumatic fever (RF) in Brazil, including direct and indirect costs to patients and their families and to society, are largely unknown. We evaluated the utilization of resources and costs related to RF in a tertiary center caring for low income patients in the city of Sao Paulo, Brazil.Methods. One hundred patients with RE younger than 18 yrs, with followup of at least one year, were sequentially selected to provide complete information on a questionnaire. Additional data were collected from patients' charts. The utilization of resources was evaluated for each patient throughout the entire disease course. Costs were determined for patients and their families as well as for the society, using variables from 3 different systems: the national public health system, used by most lower income groups; the Brazilian Medical Association, which regulates charges and fees utilized by health plans and insurance companies; and costs charged by private practitioners, paid directly by patients.Results, The RF population studied belonged to a low socioeconomic level. The mean monthly family income was $625.20 US. The mean disease duration was 3.9 yrs (range 1-10). Patients had a total of 1657 medical consultations, 22 hospital admissions, and 4 admissions to intensive care unit. Work absenteeism among parents was calculated as 22.9%, equivalent to 901 days of missed work; about 5% of the parents lost their jobs. Patients showed a high rate of school failure (22%). Considering the public system as a reference, direct, indirect, and total costs to society per 100 patients throughout the entire disease duration were $105,860 US ($271/patient/yr), $18,803 US ($48/patient/yr), and $124,663 US (US $319/patient/yr), respectively. When health care plan and private systems were taken as reference, the total costs were $423,550 US and $684,351 US, respectively.Conclusion. RF and rheumatic heart disease have an important socioeconomic impact in Brazil; costs of RF made up roughly 1.3% of annual family income. The estimated annual cost of RF for society in Brazil is $51,144,347.00 US.
Keywords rheumatic fever
children
cost of illness
resource utilization
Language English
Date 2001-06-01
Published in Journal Of Rheumatology. Toronto: J Rheumatol Publ Co, v. 28, n. 6, p. 1394-1397, 2001.
ISSN 0315-162X (Sherpa/Romeo, impact factor)
Publisher J Rheumatol Publ Co
Extent 1394-1397
Origin http://www.jrheum.org/content/28/6/1394
Access rights Closed access
Type Article
Web of Science ID WOS:000169007900030
URI http://repositorio.unifesp.br/11600/44662

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