Análise de Custo-Efetividade do uso do Sistema de Comunicação e Arquivamento de Imagens (PACS) em mamografias digitais

Abstract

This study examined the incremental cost-effectiveness ratio (ICER) of the PACS system compared to the screen /film in digital mammograms Methods: A cost-effectiveness analysis was performed comparing the use of PACS to digital mammography films in the early diagnosis of breast cancer screening setting. The outcome was the diagnostic accuracy of suspected malignant lesions, using digital mammograms with the aid of the PACS system or printed images. Results: Among 5000 women aged 50 to 69 years the effectiveness of the two technologies studied was the same (70%), the result was favorable to the use of PACS with lower cost to film in R$ 400,000.00. Among 5000 women aged 40 to 49 years, where the diagnostic effectiveness with PACS was 70% and the screen/film system was 55%, the ICER of the first technology in relation to the latter was R $ 544.24/examination for a gain of 1% in effectiveness. Conclusions: The use of PACS in aid of early diagnosis of suspicious breast lesions appeared advantageous compared to mammography through film, both in women aged 50-69 years and women between 40 and 49 years old. Given the findings suggest the implementation of PACS system in all mammography services to reduce costs and improve early diagnostic accuracy in tracking scenario, including enabling the expansion of the age range for under 50 years old without large increases costs

Three decades of telemedicine in Brazil: Mapping the regulatory framework from 1990 to 2018

“…National economic evaluation studies, such as those of cost-effectiveness, report that a high initial investment is required for implementation of telemedicine services, and it is often difficult to convince management to fund the first instance [80]. Although some claim that this cost is diluted over years [81], there is no convincing evidence to conclude whether the use of telemedicine technologies demonstrate value at an acceptable level of investment [82].…”