Análise de custos da atenção hospitalar ao parto vaginal e à cesariana eletiva para gestantes de risco habitual no Sistema Único de Saúde
Análise de custos da atenção hospitalar ao parto vaginal e à cesariana eletiva para gestantes de risco habitual no Sistema Único de Saúde
Data
2019
Autores
Entringer, Aline Piovezan
Pinto, Marcia Ferreira Teixeira
Gomes, Maria Auxiliadora de Souza Mendes
Journal Title
Journal ISSN
Volume Title
Publisher
Ciência e Saúde Coletiva
Resumo
Esse estudo estimou os custos do parto
vaginal e da cesariana eletiva, sem indicação clíni-
ca, para gestantes de risco habitual na perspectiva
do Sistema Único de Saúde provedor. A coleta de
dados incluiu três maternidades públicas situadas
na região Sudeste, nas quais foram realizadas vi-
sitas e entrevistas com os profissionais. Os itens de
custos incluídos foram recursos humanos, insumos
hospitalares, custo de capital e administrativos,
que foram identificados, quantificados e valorados
pelo método de microcusteio. Foram identificados
custos com o parto vaginal, cesariana eletiva e di-
ária em alojamento conjunto para as três mater-
nidades. A média do custo do procedimento parto
vaginal foi de R$ 808,16 e variou de R$ 585,74 a
R$ 916,14 entre as maternidades. O custo médio
da cesariana eletiva foi de R$ 1.113,70 com varia-
ção de R$ 652,69 a R$ 1.516,02. O principal item
de custo foi os recursos humanos em ambos os
procedimentos. Com a inclusão do período de per-
manência em alojamento conjunto, o custo médio
do parto vaginal foi de R$ 1.397,91 (R$ 1.287,50
- R$ 1.437,87) e da cesariana R$ 1.843,8791 (R$
1.521,54 - R$ 2.161,98), este 32% superior ao pri-
meiro. As análises de custo na atenção perinatal
contribuem para a gestão dos serviços de saúde,
além de serem essenciais para análises de custo-e-
fetividade.
This study estimated the costs of vagi- nal delivery and elective cesarean section without clinical indication, for usual risk pregnant wom- en from the perspective of the Brazilian Unified Health System. Data was collected from three public maternity hospitals located in the south- east region of Brazil through visits and interviews with professionals. The cost components were human resources, hospital supplies, capital cost and overhead, which were identified, quantified and valued through the micro-costing method. The costs with vaginal delivery, elective cesarean section and daily hospital charge in rooming for the three maternity hospitals were identified. The mean cost of a vaginal delivery procedure was R$ 808.16 and ranged from R$ 585.74 to R$ 916.14 between hospitals. The mean cost of elective ce- sarean section was R$ 1,113.70, ranging from R$ 652.69 to R$ 1,516.02. The main cost component was human resources for both procedures. When stay in rooming was included, the mean costs of vaginal delivery and cesarean were R$ 1,397.91 (R$ 1,287.50 - R$ 1,437.87) and R$ 1,843.87 (R$ 1,521.54 - R$ 2,161.98), respectively. Cost analyses of perinatal care contribute to the man- agement of health services and are essential for cost-effectiveness analysis.
This study estimated the costs of vagi- nal delivery and elective cesarean section without clinical indication, for usual risk pregnant wom- en from the perspective of the Brazilian Unified Health System. Data was collected from three public maternity hospitals located in the south- east region of Brazil through visits and interviews with professionals. The cost components were human resources, hospital supplies, capital cost and overhead, which were identified, quantified and valued through the micro-costing method. The costs with vaginal delivery, elective cesarean section and daily hospital charge in rooming for the three maternity hospitals were identified. The mean cost of a vaginal delivery procedure was R$ 808.16 and ranged from R$ 585.74 to R$ 916.14 between hospitals. The mean cost of elective ce- sarean section was R$ 1,113.70, ranging from R$ 652.69 to R$ 1,516.02. The main cost component was human resources for both procedures. When stay in rooming was included, the mean costs of vaginal delivery and cesarean were R$ 1,397.91 (R$ 1,287.50 - R$ 1,437.87) and R$ 1,843.87 (R$ 1,521.54 - R$ 2,161.98), respectively. Cost analyses of perinatal care contribute to the man- agement of health services and are essential for cost-effectiveness analysis.
Description
Palavras-chave
Custos e análise de custo, Gestão em saúde, Cesárea, Parto normal, Cost and cost analysis, Health man-agement,, Cesarean section, Natural childbirth
Citação
Entringer AP, Pinto MFT, Gomes MASM. Costs analysis of hospital care for vaginal delivery and elective caesarean section for usual risk pregnant women in the Brazilian Unified National Health System. Cien Saude Colet. 2019 Apr;24(4):1527-1536. Portuguese, English. doi: 10.1590/1413-81232018244.06962017.