RESUMO
Background: The economic impact associated with the treatment strategies of coronavirus disease-2019 (COVID-19) patients by hospitals and health-care systems in Brazil is unknown and difficult to estimate. This research describes the investments made to absorb the demand for treatment and the changes in occupation rates and billing in Brazilian hospitals. Methods: This research covers the initial findings of "COVID-19 hospital costs and the proposition of a bundled reimbursement strategy for the health-care system," which includes 10 hospitals. The chief financial officer, the chief medical officer, and hospital executives of each participating hospital provided information regarding investments attributed to COVID-19 patient treatment. The analysis included variations in occupation rates and billing from 2019 to 2020 observed in each institution, and the investments for medical equipment, individual protection materials and building construction per patient treated. Results: The majority of hospitals registered a decrease in hospitalization rates and revenue from 2019 to 2020. For intensive care units (ICUs), the mean occupancy rate ranged from 88% to 83%, and for wards, it ranged from 85% to 73%. Monthly average revenue decreased by 10%. The mean hospital investment per COVID-19 inpatient was I$6800 (standard deviation 7664), with the purchase of ventilators as the most common investment. For this item, the mean, highest and lowest acquisition cost per ventilator were, respectively, I$31â¯468, I$48â¯881 and I$17â¯777. Conclusion: There was significant variability in acquisition costs and investments by institution for responding to the COVID-19 pandemic. These findings highlight the importance of continuing microeconomic studies for a comprehensive assessment of hospital costs. Only with more detailed analyses, will it be possible to define and drive sustainable strategies to manage and reimburse COVID-19 treatment in health-care systems.
RESUMO
The aim of this study was to analyze the implementation of oral health care in the Family Health Strategy in the State of Pernambuco, Brazil, 2002 until 2005. It was observed aspects regarding the expansion of the teams, the percentage of population covered and the rise in the quantitative of oral primary procedures. It was a descriptive and quantitative study, focusing on the 185 cities included in the Family Health Strategy and all cities that included an oral health care in the program. The results showed that the evaluation of the oral health teams was 204.22%, while the percentage of the evolution of oral health care procedures 19.19%. It was observed that the expansion of the type I (327,14%) was higher than type II (125,92%). The estimation of the population covered by oral health team was about 29.56% to 3.450 inhabitants (Decree n. 673/03). The financing of oral health care primary had an increase in the same period of 389.50%. At last, it was verified, in practice, the oral care existent service to oral primary care procedures were changed in oral health teams.
