Coronary artery bypass graft surgery performance and costs by the Brazilian Public Health System (SUS) in the State of Rio de Janeiro, from 1999 to 2008.
BACKGROUND
Expenses with coronary artery bypass grafting (CABG) surgery and coronary angioplasty (CA) represented a significant cost to SUS.


OBJECTIVE
To analyze SUS expenses with CABG and CA and their performance in hospitals in the state of Rio de Janeiro (SRJ), from 1999 to 2008.


METHODS
The information came from paid HAA in hospitals with more than 100 revascularization procedures. Mortality rates were adjusted by Poisson (with covariates age, length of hospital stay and ICU expenses). Mean relative cost indices were calculated by dividing the mean value of the cost fraction spent in each hospital by the mean expense in the SRJ in U.S. dollars. Stata software was used for statistical analysis.


RESULTS
A total of 10,983 CABG and 19,661 CA were paid by SUS in 20 hospitals during the 10 years, with mean values of US$ 3,088.12 and 2,183.93, respectively. The mortality rate in CABG varied from 9.2%-1999 to 7.7%-2008, with ranges of 5.0%-9.2% and in CA, from 1.6%-1999 to 1.5%-2008, with ranges of 0.9%-2.3%. The hospitals decreased the number of CABG procedures and doubled CA procedures. Age, time of hospital stay and ICU costs significantly correlated with lethality in CABG and CA paid by SUS in the SRJ. On average, hospital service costs represented 41% of the total cost of CABG and 18% of CA, and with ortheses and prostheses, 55% in CA and 28% in CABG.


CONCLUSIONS
It is clear the need to improve the quality of healthcare service in institutions that perform CABG and CA paid by SUS.
Universidade Federal do Rio de Janeiro, RJ, Brasil. glauciam@cardiol.br
Gláucia Maria Moraes de
GM
Oliveira
Carlos Henrique
CH
Klein
Nelson Albuquerque de Souza e
NA
Silva
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000191:economics* / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data; D001938:Brazil; D001026:Coronary Artery Bypass / Q000191:economics* / Q000401:mortality / Q000592:standards / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis / Q000379:methods; D017052:Hospital Mortality; D006761:Hospitals / Q000145:classification / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000592:standards; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D016012:Poisson Distribution; D013997:Time Factors