title: Comparison of thromboprophylaxis patterns in arthroplasty in public and private hospitals.
abstract: OBJECTIVE
  To compare therapy for prophylaxis of venous thromboembolism and costs related to hospitalization of patients undergoing total knee and hip replacement within the context of the Brazilian health system.
  
  
  METHODS
  A retrospective study of patients undergoing arthroplasty in 2010 in a public hospital and two private hospitals in the state of São Paulo, conducted by means of medical record review. Costs were estimated based on the use of health care resources during hospitalization. A descriptive analysis was performed using frequency and mean (standard deviation) according to the type of care delivered (by public or private organization).
  
  
  RESULTS
  A total of 215 patients were evaluated, and 56.3% were submitted to knee surgery and 43.7%, to hip replacement. Approximately 88% and 98% of patients from public and private health services, respectively, received some form of venous thromboembolism prophylaxis, and enoxaparin was the drug most widely used in both systems. The total cost of prophylaxis was R$ 1,873.01 (R$ 26.38 per patient) in the public service and R$ 21,559.73 (R$ 163.33 per patient) in the private service. For the individuals who presented with thromboembolism, the average cost of hospitalization was R$ 6,210.80 and R$ 43,792.59 per patient in public and private health services, respectively.
  
  
  CONCLUSIONS
  Thromboembolism prophylaxis in patients undergoing arthroplasty is most commonly used in the private health services than public organizations, despite its high costs in both services. The cost per patient with thrombosis during hospitalization was higher than the total cost of prophylaxis, suggesting that prevention is associated to better cost-benefit ratio.
authors: Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
authors: Aline Pinheiro dos Santos
authors: AP
authors: Cortada
authors: Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
authors: Telma Gomes da
authors: TG
authors: Silva
authors: Associação de Assistência à Criança Deficiente, São Paulo, SP, Brazil.
authors: André Campos da
authors: AC
authors: Silva
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Ricardo Prado
authors: RP
authors: Golmia
authors: ANOVA Consultoria em Saúde, Rio de Janeiro, RJ, Brazil.
authors: Renata Leborato
authors: RL
authors: Guerra
authors: ANOVA Consultoria em Saúde, Rio de Janeiro, RJ, Brazil.
authors: Maíra Libertad Soligo
authors: ML
authors: Takemoto
authors: Bristol-Myers Squibb, São Paulo, SP, Brazil.
authors: Roberta Dyonisio Canaveira
authors: RD
authors: Monteiro
authors: Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
authors: Morton Aaron
authors: MA
authors: Scheinberg
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000191:economics; D019645:Arthroplasty, Replacement, Knee / Q000191:economics; D001938:Brazil; D003362:Cost-Benefit Analysis / Q000191:economics*; D017984:Enoxaparin / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000191:economics; D016304:Hospitals, Private / Q000191:economics*; D006779:Hospitals, Public / Q000191:economics*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin