Diferencial de custos da internação para o parto de gestantes com diabetes em uma maternidade pública de Salvador.

Abstract

In Brazil, diabetes is considered the main metabolic disease during pregnancy. Gestational Diabetes is defined as any degree of glucose intolerance, whose diagnosis occurs at the beginning of pregnancy, and may or may not persist afterwards. The lifestyle of pregnant women and / or hereditary burden are considered important factors for the development of the disease. Pregnant women with diabetes tend to have greater complications in pregnancy and there are greater possibilities for complications, reflecting a higher cost for health services and an impact on families. The general objective of the study is to estimate the difference in direct medical costs of hospitalization for delivery of pregnant women with diabetes and without the disease, in a public maternity hospital in Salvador / Bahia, in 2016 from the perspective of the Unified Health System. it is an observational, longitudinal study of the retrospective paired case-control type, of disease cost assessment, with a quantitative approach. For the collection of data from the clinical epidemiological profile, information from the records of the 135 patients and data from their hospital systems were used. In order to estimate the costs of patients in each group, data were collected regarding the number of tests and medication used, delivery mode, hospitalization of pregnant women in the ward and newborns in UTINEO. Descriptive statistical analysis was performed with a mean difference test to obtain the average cost and check the significance of the difference. The results for the case and control groups were found respectively: Type of delivery: cesarean section - 81.4% vs 24.6%, normal delivery - 18.6% vs 75.4%; Hospitalization of pregnant women for clinical complications: only those in the case group admitted, which corresponds to 30% of pregnant women in the group; NB admitted to the ICU: 23.2% vs 4.61%. The average total cost was R $ 9,463.4 vs R $ 5,986.53.3 case and control respectively. All items had higher values in the case group. The cost item that contributed to a greater difference between the groups was the admission to the pregnant woman and what reduced this difference was the admission of the NB to the ICU. The average incremental cost can be up to 58.8% more for pregnant women with diabetes. This higher proportion corresponded to an incremental differential of R $ 3,476.9 for pregnant women with diabetes hospitalized for childbirth in the year 2016. It is evident that the delivery of pregnant women with gestational diabetes is also more financially costly for SUS greater possibility of unfavorable outcomes, therefore reinforcing prevention and early diagnosis measures are necessary and urgent to minimize the health impacts of women and their children.