GID are common in dogs undergoing general anesthesia. Duration and characteristics of the procedure, anesthetic management, and changes in certain patient variables are significant risk factors for the presence of GID in the perioperative period.

No abstract

Objectives: Diseases caused by Streptococcus pneumoniae (pneumococcal diseases [PDs]) are a major public health problem worldwide1. This bacterium causes severe pulmonary and invasive diseases, such as pneumonia, meningitis and septicemia, affecting especially young children and the elderly, being responsible for one million children deaths per year1,2. Acknowledging that PDs are an important burden on health systems, this study aims to estimate the impact of deaths from PDs from the Brazilian Private Healthcare System (PHS) perspective. MethOds: The number of hospital discharges due to PD-related deaths (meningitis, pneumonia or septicemia), as well as the hospitalization costs and resources usage by PHS were analyzed using a database with approximately 200,000 patients3, between September 2014 and August 2015. Results: From the 426 users identified, 18 users were excluded for lack of information and, then, 130 users were identified with one of the PDs (meningitis, pneumonia or septicemia) considered in this study. It was observed that 60% of the deaths were from pneumonia, 38% from septicemia and 2% from meningitis and related total costs of hospitalization were BRL 1,202,921.02, BRL 1,253,653.65, BRL 79,808.28, respectively. The related total cost of hospitalization for all diseases was BRL 7,587,496.19, compared to BRL 2,536,382.95 of hospitalization for PDs (meningitis, pneumonia and septicemia). The average length of stay was 9 days for pneumonia, 12 days for septicemia and 13 days for meningitis. The highest number of deaths relates to elderly people (91%). cOnclusiOns: Pneumococcal diseases represent a total of 33% of death-related costs for Brazilian PHS, affecting especially elderly people. The total cost of hospitalization was 6% higher than overall costs and the average length of stay until death was greater than for the other diseases analyzed.

diversity of the health professionals and the basic scenario. The costliest scenarios were the one implementing HPV DNA testing which did not provide further participation despite a high cost and the one based on P4P incentives towards GP, although it allows high participation rates. ConClusions: Using a comprehensive BIM, we show that full coverage of OS might be the most cost-effective way to implement it, although practical and financial issues might favour other scenarios that may be more balanced regarding the distribution of costs between stakeholders or may be more easily implemented and accepted by health professionals.