Avaliação econômica em Saúde na esfera de atenção local à saúde

Sancho, Leyla Gomes; Vargens, José Muniz Costa

doi:10.1590/s1413-81232009000800025

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…The inability to manage effectively high-cost technologies in large institutions is similar to other cases studied in Brazil (Scheffer, 2008;Sancho, Vargens, 2009). Gertner (2010) followed up on the economic analyses performed by a company working for the pharmaceutical industry, showing that artificial demand was built for a new technology within the system, thus creating a market where there was none before.…”

Section: Discussionsupporting

confidence: 61%

The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

Lima

Caetano

Osório-de-Castro

2015

Braz. J. Pharm. Sci.

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Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC) is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.Uniterms: Medicines/selection. Drug and Therapeutic Committees. University hospitals/medicines selection.A produção de conhecimento sobre a seleção de medicamentos baseada em evidências e executada por Comissões de Farmácia e Terapêutica é ainda escassa no Brasil, apesar da ampla discussão sobre o tema em países desenvolvidos. Este estudo buscou conhecer e analisar os aspectos relacionados à seleção de medicamentos em quatro hospitais universitários de grande porte no Rio de Janeiro, por meio de abordagem qualitativa. Entrevistas, observação direta e análise documental instrumentaram a coleta de dados qualitativos e quantitativos. A análise considerou duas dimensões: (i) estrutura e organização para o processo de seleção e (ii) critérios e métodos utilizados para avaliação. Apenas dois hospitais possuíam Comissão de Farmácia e Terapêutica (CFT) ativa. A estrutura para a tomada de decisão era deficiente e os membros das Comissões apontaram pouca experiência e disponibilidade para a atividade. Os métodos de avaliação e critérios observados indicaram um processo de seleção acrítico nestes hospitais, comprometendo a assistência farmacêutica e potencialmente prejudicando o sistema de saúde. Apesar da metodologia qualitativa não permitir a extrapolação de resultados, é possível que este cenário seja parecido com o de outros hospitais universitários brasileiros.Unitermos: Medicamentos/seleção para uso.

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Section: Discussionsupporting

confidence: 61%

The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

Lima

Caetano

Osório-de-Castro

2015

Braz. J. Pharm. Sci.

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“…Its results are not much used, and even in the international level, it is rarely employed to subsidize planning 21 and decision-making. Coast 7 justifi es this assertion through the insuffi cient knowledge about the methods, and it is possible to add the incipient degree of institutionalization of the evaluative culture of public policies in the Brazilian reality.…”

Section: Discussionmentioning

confidence: 99%

Estudo exploratório de custos e conseqüências do pré-natal no Programa Saúde da Família

et al. 2011

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OBJECTIVE:To assess costs and consequences of prenatal care on perinatal morbidity and mortality. METHODS:Evaluation study using two types of analysis: implementation and effi ciency analysis, carried out at 11 Family Health Units in the Recife, Northeastern Brazil, in 2006. The costs were calculated by means of the activity-based costing technique and the cost-effectiveness ratio was calculated for each consequence. Data sources were information systems of the Ministry of Health and worksheets of costs provided by the Health Department of Recife and Instituto de Medicina Integral Prof. Fernando Figueira. Healthcare units with implemented or partially implemented prenatal care were compared in terms of their cost-effectiveness and perinatal results. RESULTS:In 64% of the units, prenatal care was implemented with a mean total cost of R$ 39,226.88 and variation of R$ 3,841,87 to R$ 8,765.02 per healthcare unit. In the units with partially implemented prenatal care (36%), the mean total cost was R$ 30,092.61 (R$ 4,272.12 to R$ 11,774.68). The mean cost per pregnant woman was R$ 196.13 with implemented prenatal care and R$ 150.46 with partially implemented prenatal care. A higher proportion of low birth weight, congenital syphilis, perinatal and fetal deaths was found in the partially implemented group. CONCLUSIONS:Prenatal care is cost-effective for several studied consequences. The adverse effects measured by the health indicators were lower in the units with implemented prenatal care. The mean cost in the partially implemented group was higher, which suggests a possible waste of resources, as the teams' productivity is insuffi cient for the installed capacity.

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Brazilian Health Technology Assessment Bulletin: Editorial Process, Dissemination Strategies, Critical Appraisal, and Initial Impact

Silva

Almeida

Gava³

et al. 2012

Int J Technol Assess Health Care

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Avaliação econômica em Saúde na esfera de atenção local à saúde

Abstract: Avaliação econômica em Saúde na esfera de atenção local à saúdeHealth economic evaluation in a local level government health care system

Cited by 5 publications

References 12 publications

The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

Estudo exploratório de custos e conseqüências do pré-natal no Programa Saúde da Família

Brazilian Health Technology Assessment Bulletin: Editorial Process, Dissemination Strategies, Critical Appraisal, and Initial Impact

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