Banca de DEFESA: VALERIA LIMA BOTELHO
Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.DISCENTE : VALERIA LIMA BOTELHO
DATA : 09/12/2020
HORA: 14:30
LOCAL: Remotamente
TÍTULO:
ANALYSIS OF EXPENDITURE ON TREATMENT OF HIP OSTEONECROSIS: CELL THERAPY AND TOTAL ARTHROPLASTY IN PEOPLE WITH ANEMIA FALCIFORM IN THE SUS PERSPECTIVEPALAVRAS-CHAVES:
Health Spending, Sickle Cell Anemia. Osteonecrosis of the Femoral Head. Hip arthroplasty. Cell Therapy, Health Technology.
PÁGINAS: 48
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
RESUMO:
Sickle Cell Disease is defined as an autosomal recessive disorder characterized by the presence of abnormal hemoglobin S. Sickle Cell Disease is originating from the African continent. Due to the long historical process of intense enslavement of African peoples and colonization of Brazil, the black population is the most affected. The S gene is more prevalent in Bahia and Salvador. Approximately 50% of patients with Sickle Cell Disease have avascular necrosis, which mainly affects the head of the femur. The treatment of osteonecrosis of the femoral head is considered a challenge. Traditionally, the therapy used is total hip arthroplasty, which corresponds to an invasive procedure with high rates of morbidity and mortality and unsatisfactory results after 5 to 10 years. Cell therapy, with the use of stem cells, proves to be an important alternative to be incorporated into SUS in the treatment of hip osteonecrosis. Patients with Sickle Cell Disease present better prognosis with cell therapy, featuring a 5% failure rate. Considering the efficiency of cell therapy, the objective of the present work was to perform an analysis of the effective spending on this therapy in hip osteonecrosis in people with sickle cell disease, in the context of SUS. For this purpose, a descriptive, comparative and crosssectional study was developed of people assisted at the Professor Edgard Santos University Hospital Complex, with hip osteonecrosis secondary to Sickle Cell Disease and submitted to cell therapy, in the age group of 18 to 40 years old, in the period from 2015 to 2019. From the medical records of the patients, the expenses of cell therapy and total hip arthroplasty were estimated for analysis and comparison purposes. To evaluate health expenditures, the microcosting methodology was applied and the SUS perspective was used as the purchasing organization of public and private health services. All direct expenses were computed based on the coverage of the reimbursement tables of SUS procedures. In addition, data from DATASUS were consulted. Concerning cell therapy in hip osteonecrosis from 2015 to 2019, 74 patients were tended, with 88 surgical procedures being performed. The results showed that the expenses obtained with each procedure were R$ 3,265.22 for cell therapy and R$ 4,764.08 for total hip arthroplasty. Based on scientific evidence, the loosening of prostheses referring to primary total arthroplasty in Sickle Cell Disease, where the value of R$ 4,764.08 has an average useful life of 5 to 10 years, requires a total revision arthroplasty, a procedure with estimated expenses of R$ 6,365.18. Therefore, the expenses are even higher compared to cellular therapy, with an increase of R$ 7,864.04 per procedure. In this context, from the evaluation of the expenses considering the 74 patients analyzed, it was verified that, while cellular therapy generated an expense of R$ 287,339.36, if the traditional method was adopted, the amount spent would be R$ 979,374.88. Then, through the analysis carried out, cell therapy proved to be more economical, being a treatment that makes it possible to treat more people in less time.
MEMBROS DA BANCA:
Interno - 2425791 - ERIKA SANTOS DE ARAGAO
Externo ao Programa - 286128 - GILDASIO DE CERQUEIRA DALTRO
Externo ao Programa - 1323871 - MARCIO SANTOS DA NATIVIDADE
Externo ao Programa - 286053 - MARIO CASTRO CARREIRO
Externo à Instituição - SUSANA BEATRIZ SNEIDERMAN