Estimativa de custos evitados atribuídos a um programa de rastreio de colo curto para prevenção da prematuridade na perspectiva do SUS

Autores/as

DOI:

https://doi.org/10.11606/s1518-8787.2023057004376

Palabras clave:

Recém-Nascido Prematuro, Colo do Útero, Programas de Rastreamento

Resumen

OBJETIVO: Realizar uma análise econômica de custo da implementação de um programa de rastreio de colo curto para redução da prematuridade em gestações únicas num horizonte temporal de curto prazo. MÉTODOS: Realizamos uma análise econômica do tipo custo-benefício utilizando o banco de dados do P5 trial, um ensaio clínico multicêntrico randomizado para prevenção da prematuridade. A coleta de dados ocorreu de julho de 2015 a março de 2019 em 17 diferentes hospitais do Brasil. Comparamos os custos do rastreamento universal em mulheres com gestação única de 18 a 22 semanas e 6 dias associado à progesterona vaginal profilática 200 mg/dia até 36 semanas naquelas com colo ≤ 25 mm com os do não rastreamento. O horizonte temporal foi do nascimento até 10 semanas após o parto. O desfecho foi medido monetariamente em real brasileiro (R$) na perspectiva do Sistema Único de Saúde. RESULTADOS: Entre 7.844 mulheres, 6,67% (523) apresentaram colo ≤ 25mm. O custo do rastreio com a ultrassonografia transvaginal mais a progesterona vaginal para prevenção de nascimentos < 34 semanas foi estimado em R$ 383.711,36, enquanto o não rastreamento gerou custo adicional estimado de R$ 446.501,69 (relacionado aos 29 partos prematuros não rastreados). Assim, o rastreamento mais a profilaxia geraria uma redução de custo final de R$ 62.790,33, apresentando-se como uma possível estratégia de custo-benefício. CONCLUSÃO: O rastreamento universal de colo curto para prematuridade apresenta menores custos em relação ao não rastreamento dentro de um horizonte temporal de curto prazo, o que sugere uma interessante relação de custo versus benefício. Novos estudos que considerem a custo-efetividade do tratamento profilático utilizando-se de análises de sensibilidade em diferentes cenários dentro do sistema de saúde brasileiro, assim como análises que considerem os custos de longo prazo atrelados ao nascimento prematuro, são necessários para justificar com robustez a implementação de um programa de rastreamento.

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Publicado

2023-11-10

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Artigos Originais

Cómo citar

Silva, T. V., Borovac-Pinheiro, A., & Pacagnella, R. C. (2023). Estimativa de custos evitados atribuídos a um programa de rastreio de colo curto para prevenção da prematuridade na perspectiva do SUS. Revista De Saúde Pública, 57(1), 87. https://doi.org/10.11606/s1518-8787.2023057004376

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