Congenital cardiac disease in childhood x socioeconomic conditions: a relationship to be considered in public health? / Cardiopatia congênita na infância x condições socioeconômicas: uma relação a ser considerada na saúde pública?

Introduction: Congenital heart defects, cardiac malformations that occur in the embryonic period, constitute a serious health problem. They cover a proportion of 8-10 per 1000 live births and contribute to infant mortality. Objective: To identify the socioeconomic status of children undergoing cardiac surgery at the Hospital Universitário da Universidade Federal do Maranhão, in São Luis, the existence of material elements that contribute to worsening conditions. Methods: We conducted a retrospective study with a quantitative approach, descriptive and reflective, from the interviews conducted by the Social Service Social with families of children with heart disease from January 2011 to July 2012. Results: A total of 95 interviews, the results reveal that (75.79%) of children have elements that suggest poor socioeconomic conditions. It also shows that only 66.33% lived in brick house, while (31.73%) in mud, adobe and straw houses. With regard to income, it showed that only 4.08% received 1-2 minimum wages, while the remaining (95.9%) with benchmarks oscillating half the minimum wage (27.55%), 1/4 of the minimum wage and (24.48%) and income below 70 dollars per person, featuring extreme poverty. On the social security situation prevailing at children with no ties to 61.22%. With respect to benefits, we found that only (12.24%) of children were in the enjoyment of the Continuous Cash Benefit - CCB. Conclusion: Poor socioeconomic conditions listed as major obstacles in meeting the needs, resulting in the maintenance of health conditions and even allowing the aggravation of an existing pathology. .

Introdução: As cardiopatias congênitas, são malformações cardíacas que ocorrem no período embrionário e configuram um sério problema de saúde. Incidem numa proporção de 8 a 10 em cada 1000 crianças nascidas vivas e contribuem para mortalidade infantil. Objetivo: Identificar na situação socioeconômica das crianças submetidas à cirurgia cardíaca no Hospital Universitário em São Luís a existência de elementos materiais que concorrem para o agravamento desta afecção. Métodos: Realizou-se um estudo retrospectivo, com abordagem quantitativa de caráter descritivo-reflexivo, a partir das entrevistas sociais realizadas pelo Serviço Social junto às famílias das crianças cardiopatas no período de janeiro de 2011 a julho de 2012. Resultados: De um total de 95 entrevistas, os resultados revelaram que pelo menos 75,79% das crianças apresentaram elementos que sugerem condições socioeconômicas precárias. Evidenciaram que somente 66,33% viviam em casa de tijolo, enquanto 31,73%, em casas de taipa, adobe e palha. No que concerne à renda, foi constatado que apenas 4,08% das famílias recebiam de 1 a 2 salários mínimos, enquanto os demais 95,9% possuíam aferimentos oscilantes de 1/2 salário mínimo; 27,55% de 1/4 do salário mínimo e 24,48% renda inferior a 70 reais por pessoa, caracterizando situação de extrema pobreza. Sobre a situação previdenciária prevaleceram as crianças sem vínculo com (61,22%). No que tange a benefícios, observou-se que somente 12,24% delas estavam em gozo de Benefício de Prestação Continuada - BPC. Conclusão: condições socioeconômicas precárias figuram como importantes obstáculos no atendimento das necessidades ...

Socioeconomic status and impact of treatment on families of children with congenital heart disease

To assess the socioeconomic status, treatment being offered and the impact of congenital heart disease treatment on families. Observational study. The Children's Hospital / Institute of Child Health, Lahore, from 1st March to 31[st] August 2010. All patients undergoing a cardiac surgical or angiographic intervention were enrolled. Socioeconomic status was assessed by Kuppuswamy socioeconomic status scale with income group modification. The impact was measured by the source of financing, effect on family financing source and schooling and health of siblings. Of 211 patients undergoing treatment in the study period, surgery was the definitive treatment in 164 [77.7%] and angiographic intervention in 47 [22.3%] patients. Male to female ratio was 1.5:1. The mean age of the patient was 39.1 +/- 3.2 months [range 01 day to 15 years]. Majority of families belonged to middle [66.4%, n=140] and lower [27%, n=57] socioeconomic class. The mean cost of medicines and disposables was PKR 78378.2 +/- 8845.9 [US$ 933.1 +/- 105.3] in open heart surgery, PKR 12581 +/- 7010.8 [US$ 149.8 +/- 83.5] in closed heart surgery and PKR 69091 +/- 60906 in angiographic interventions. In 63.1% patients, families contributed towards these costs either completely [12.3%] or partly [50.8%] with significant contribution from the hospital. Adverse effect on families ranged from leave without pay to losing jobs or business [46%], and selling their assets [11.3%]. It also affected schooling and health of siblings [22.7% and 26.1% respectively]. Majority of children with congenital heart disease belonged to middle and lower socioeconomic status in this study. Main definitive treatment was surgery. The cost of health care facilities posed a marked socioeconomic burden on those families

Device occlusion versus surgery for closure of congenital heart defects: cost issues in Iran

Closure of patent ductus arteriosus [PDA], ventricular septal defect [VSD] and atrial septal defect [ASD] can be done surgically or by device. This study was designed to compare the total cost of surgical or device closures of PDA, ASD or VSD for Iranian patients. This is a cross-sectional study, conducted from January 1, 2005 until January 1, 2006 in two large heart centers of Tehran. The study population consisted of 91 patients with isolated PDA, ASD or VSD who underwent either surgical or device closure. PDA device closure either with the Amplatzer device or coil was less costly than that via surgery. VSD closure with the Amplatzer device was more costly [17.6%]. Although ASD closure was also more expensive [15.4%], the difference was not statistically significant. It can be concluded that PDA closure is cheaper than surgery in Iran. ASD and VSD device closures are more expensive, but the added cost can be affordable in view of the advantages of device closure