The cost of transcatheter aortic valve implantation according to different access routes

Abstract

Objective:Identifying the average direct cost of TAVI (Transcatheter Aortic Valve Implantation) for the different access routes. Method: This is a research with a quantitative, exploratory and descriptive approach carried out in a government teaching hospital in the state of São Paulo. Results: The average direct cost of TAVI procedures by the access routes resulted in R$82,826.38 (transfemoral route), R$79,440.91 (transaortic route) and R$78,173.41 (transapical route). The transcatheter valve cost represented a percentage variation between 78.47% and 83.14% of the total cost of the procedure. The Kruskal-Wallis test was used and presented a statistically significant difference between the three access routes: p=0.008. The Bonferroni test showed a difference in the association between transfemoral and transapical routes, while no statistically significant difference was observed in association with the transaortic route. Conclusion: The results are important for formulating adequate funding policies for the hospital network and understanding the costs according to the route facilitates rationalizing resources in order for them to be guaranteed for patients who present surgical contraindication to the valve implant.

Coverage for the cost of outpatient nursing procedures by the Unified Health System: a percentage analysis

“…The individual costs of procedures are the basis for the financial management of health units and, without the budget dimension, any attempt at improving the process of negotiation with SES is impossible (11) .…”

“…Calculation of procedure costs and its comparison with the values of financial transfers from SUS aim at helping hospital managers negotiate and readjust contracting (11)(12) .…”

“…Many studies comparing the values of transfers from SUS in face of the high cost of procedures also identified the real problem of underfinancing of public hospitals in which coverage of these values fall short of the actual values. This budget deficit, associated to an increase in users who rely exclusively on this system, intensifies the crisis and leads to poor care quality (5,(11)(12)(13) .…”

Tratamento da Estenose Aórtica do Idoso no Brasil: Até Quando Podemos Esperar?

“…10,11 The approximate cost per transfemoral implantation is estimated at R$ 82,826.38, with the prosthesis corresponding to about 80% of this amount. 12 Conitec defended that the budgetary impact estimate was not the main determinant for its unfavorable opinion, but gave evidence contrary to this assertion when insisted on maintaining the estimate at levels completely dissonant from the reality of health care in Brazil, especially concerning the SUS. The new budgetary impact estimate was calculated after public consultation but was presented without emphasis in the final report (restricted to two lines on page 25), hindering its visibility, while the prior estimate modified by Conitec after the public consultation continued to be largely detailed on a table over several pages (for example, pages 17, 18, and 19), leading the reader to an inaccurate conclusion that this would still be the estimate that the commission considered to be correct.…”