Hospitalization costs of severe bacterial pneumonia in children: comparative analysis considering different costing methods

Abstract

Objective To determine and compare hospitalization costs of bacterial community-acquired pneumonia cases via different costing methods under the Brazilian Public Unified Health System perspective.Methods Cost-of-illness study based on primary data collected from a sample of 59 children aged between 28 days and 35 months and hospitalized due to bacterial pneumonia. Direct medical and non-medical costs were considered and three costing methods employed: micro-costing based on medical record review, micro-costing based on therapeutic guidelines and gross-costing based on the Brazilian Public Unified Health System reimbursement rates. Costs estimates obtained via different methods were compared using the Friedman test.Results Cost estimates of inpatient cases of severe pneumonia amounted to R$ 780,70/$Int. 858.7 (medical record review), R$ 641,90/$Int. 706.90 (therapeutic guidelines) and R$ 594,80/$Int. 654.28 (Brazilian Public Unified Health System reimbursement rates). Costs estimated via micro-costing (medical record review or therapeutic guidelines) did not differ significantly (p=0.405), while estimates based on reimbursement rates were significantly lower compared to estimates based on therapeutic guidelines (p<0.001) or record review (p=0.006).Conclusion Brazilian Public Unified Health System costs estimated via different costing methods differ significantly, with gross-costing yielding lower cost estimates. Given costs estimated by different micro-costing methods are similar and costing methods based on therapeutic guidelines are easier to apply and less expensive, this method may be a valuable alternative for estimation of hospitalization costs of bacterial community-acquired pneumonia in children.

Developing the Pneumonia-Optimized Ratio for Community-acquired pneumonia: An easy, inexpensive and accurate prognostic biomarker

“…Regarding the public health system in low and middle-income countries, health depenses are decisive for equality and distribution of care. CAP is still a major public health issue in these countries, especially because of the costs of hospital admissions and severe cases [26]. The usage of simple prognostic biomarkers are stimulated due to their increased ability to predict death in such contexts [27].…”

Padrões de tratamento, uso de recursos e custo do câncer de pulmão de não pequenas células avançado em instituições brasileiras privadas

“…O custo total do paciente por mês neste estudo foi maior do que os relatados na Europa, Estados Unidos, Holanda, Espanha e outros estudos brasileiros (Tanaka et al, 2016;Corral et al, 2015;van der linden et al, 2016;Solem et al, 2015b;McGuire et al, 2015). Algumas diferenças de custo podem ser devidas a diferenças inerentes à metodologia escolhida (Nunes et al, 2017) e a suposições e condução dos estudos (Ó Céilleachair et al, 2013). Especificamente no Brasil, os estudos são do sistema público de saúde (Knust et al, 2017) ou têm informações limitadas sobre o atendimento ao paciente, além do tratamento (Tanaka et al, 2016;Ferreira et al, 2015).…”

Antimicrobial Resistance of Microorganisms Causing Pneumonia in Patients of a Public Hospital in Brazilian Pre-Amazon Region

“…Even with advances in diagnosis and treatment, about 450 million people are still affected every year in the world. In Latin America, up to 1.5 million children under the age of five are infected, leading to the death of approximately 4 million annually [8][9][10]. Brazil is one of the countries with the highest number of cases [8].…”

“…In Latin America, up to 1.5 million children under the age of five are infected, leading to the death of approximately 4 million annually [8][9][10]. Brazil is one of the countries with the highest number of cases [8]. According to the Brazilian information system of the Unified Health System (SUS/DATASUS), between 1996 and 2012, pneumonia was responsible for 37% of deaths related to the respiratory system [11].…”