Public private partnership in vascular surgery

Abstract

Objective To describe and analyze the results of a public-private partnership between the Ministry of Health and a private hospital in a project of assistance and scientific research in the field of endovascular surgery. Methods: The flows, costs and clinical outcomes of patients treated in a the public-private partnership between April 2012 and July 2013 were analyzed. All patients underwent surgery and stayed at least one day at the intensive care unit of the private hospital. They also participated in a research protocol to compare two intravenous contrast media used in endovascular surgery (iodinated contrast and carbon dioxide).Results A total of 62 endovascular procedures were performed in 57 patients from the public healthcare system. Hospital and endovascular supplies expenses were significantly higher as compared to the amount paid by the Unified Health System (SUS - Sistema Único de Saúde) in two out of three disease groups studied. Among outpatients, the average interval between appointment and surgery was 15 days and, in hospitalized patients 7 days. All procedures were successful with no conversion to open surgery. The new contrast medium studied - carbon dioxide – was effective and cheaper.Conclusion The waiting time for patients between indication and accomplishment of surgery was significantly reduced. Public-private partnerships can speed up care of patients from public health services, and generate and improve scientific knowledge.

Carbon dioxide contrast medium for endovascular treatment of ilio-femoral occlusive disease

“…An alternative that has been used within the last 15 years is carbon dioxide (CO 2 ), which is used for patients with renal impairment or hypersensitivity to iodine because it is non-nephrotoxic and non-allergenic 5 . With improvements in both imaging equipment and injection techniques, CO 2 has even been used in patients without contraindications to ICM for the detection of endoleaks 6 , femoral-popliteal angioplasty 7 , 8 , cavography for vena cava filter placement 9 and investigation of the biliary tree 10 .…”

Limitações do acesso à informação sobre contratação pública em saúde no Brasil à luz da Lei de Acesso à Informação

“…Sobre a contratação de serviços profissionais, Barbosa (2017) destacou a discrepância entre a dinâmica organizacional e a base de dados disponível para acesso, concluindo que esta base não refletia todos os aspectos a serem considerados para uma possível avaliação dos serviços contratados. Kaliks et al (2013) reforçaram as diferenças de gastos do setor privado para a prestação do serviço contratado em relação à remuneração do setor público, devido à desatualização da "Tabela SUS" ou do Sistema de Gerenciamento da Tabela de Procedimentos, Medicamentos e OPM (DESGUALDO et al, 2011), e diferenças desses setores também em relação à agilidade e qualidade do atendimento das demandas (LANSKY et al, 2007;MENDES et al, 2014), entre outros.…”

“…Em razão da defasagem de valores indicados nos bancos de dados utilizados como parâmetro para reembolso de serviços prestados ao SUS, os referidos valores tornam-se fictícios, impossibilitando a aproximação real dos custos com contratação pública para o setor saúde, com utilização de complementação financeira dos entes federativos (ROMANO; SCATENA, 2014), prática de valores muito acima da tabela (MENDES et al, 2014) e ausência de registro dos valores reais praticados pela administração pública.…”

“…Verifica-se a utilização dos bancos de dados privados quando os pesquisadores possuem vínculos empregatícios com as instituições cujas informações são analisadas nos artigos (GONZÁLEZ; CALIMAN, 2018;MENDES et al, 2014;KALIKS et al, 2013), sendo que estes artigos destacam como pontos relevantes as vantagens da contratação pública e/ou defasagem dos valores ressarcidos pela administração pública aos serviços e/ou bens contratados em relação aos valores praticados no mercado privado.…”

Maximizing the efficiency of residents operating room scheduling: a case study at a teaching hospital

“…In order to perform these procedures, sophisticated equipment, qualified teams and intensive care units (ICU) prepared for the postoperative period are necessary. The increase in the life expectancy of a population causes a higher prevalence of this type of disease, which has imposed a significative burden to the Brazilian Unified Health System (SUS) (Mendes et al, 2014).…”