title: [In hospital care for diabetic foot: a comparison between the estimated cost and the SUS reimbursement].
abstract: This study aimed to analyze costs for treating patients with diabetic foot cared by the public Brazilian Health System (SUS), comparing the estimated cost with the amount of SUS reimbursement. A cohort prospective study carried out in hospitals that provide services for the Unified Health System in Sergipe, involving 109 hospitalization episodes of patients with diabetes and foot ulcers. We follow these patients day by day and estimated the hospital direct cost and the SUS reimbursement. All patients had type 2 diabetes and the majority of ulcers (64.2%) were classified as Wagner 4 or 5. Forty-three (39.4%) healed without amputation and fifty-two (47.7%) healed with amputation. Fourteen (12.8%) patients died. Hospital direct cost ranged from R$ 943.72 to R$ 16,378.85; with an average of R$ 4,461.04. The SUS reimbursement varied from R$ 96.95 to R$ 2,410.18, with an average of R$ 633.97, usually seven times low. Smaller difference between costs occurred in patients from the Beneficent hospital and higher rates occurred in those treated with minor amputation.
authors.affiliation: Universidade Federal de São Paulo, Brasil. kfr@oi.com.br
authors.forename: Karla F
authors.initials: KF
authors.lastname: Rezende
authors.forename: Marco A P
authors.initials: MA
authors.lastname: Nunes
authors.forename: Naira H
authors.initials: NH
authors.lastname: Melo
authors.forename: Domingos
authors.initials: D
authors.lastname: Malerbi
authors.forename: Antônio R
authors.initials: AR
authors.lastname: Chacra
authors.forename: Marco B
authors.initials: MB
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000191:economics; D001938:Brazil; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics* / Q000592:standards; D017719:Diabetic Foot / Q000191:economics* / Q000628:therapy; D004812:Epidemiologic Methods; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics* / Q000592:standards; D012051:Reimbursement Mechanisms; D017678:Sex Distribution; D012959:Socioeconomic Factors