Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120

 

Presentation

The evolution of public expenditure with renal replacement therapy (RRT) in Brazil - 2000 to 2004

Authors: Mariângela Leal Cherchiglia (Federal University of Minas Gerais); Grazielle Dias da Silva (Federal University of Minas Gerais); Francisco Acúrcio (Federal University of Minas Gerais); Eli Iola Gurgel Andrade (Federal University of Minas Gerais); Daniele Araújo Campos Szuter (Brazillian Ministry of Health); Augusto Afonso Guerra Júnior (Brazillian Ministry of Health); Daniel Resende Faleiros (Brazillian Ministry of Health); Wellington de Freitas Vieira (Federal University of Minas Gerais); Odilon Vanni de Queiroz (Federal University of Minas Gerais); Elias Antonio Jorge (Brazillian Ministry of Health); Vania Lacerda Macedo (Brazillian Ministry of Health)

Presenter: Francisco Acurcio (Federal University of Minas Gerais (UFMG))

Session: Poster Session

Room: Kirby Winter Garden

When: Monday 2:30 p.m. - 3:15 p.m.

Rationale: Chronic renal failure in Brazil presents with social and economical relevant effects. The Brazilian Unified Health System (SUS) provides assistance and treatment for 95% of the patients in dialysis and almost 100% of renal transplant patients. This means a substantial volume of public financial resources allocated to renal replacement therapies (RRT). The prevalence of patients currently under RRT is 390 pmp lower than what is observed in developed countries.

Objectives: To analyze the evolution of expenditure and assistance coverage to patients in RRT in Brazil from 2000 to 2004.

Methodology: Patients assisted by RRT had were identified in the Ministry of Health's database (DATASUS). Annual expenses were corrected by the general index of inflation and estimated to the values of October 2006 (in US dollars). The rate of real growth (r) in the analyzed period was also calculated.

Results: USD 2,73 Billion was spent with RRT procedures from 2000 to 2004 in Brazil, excluding hospital expenses with transplantation. This represented an average of 3.2% of the Ministry of Health annual healthcare budget and 30,5% of the total expenditure with high complexity procedures. Investments varied from USD 484 to 582 millions. The mean annual expenditure was USD 546 millions to assist an average of 68.000 patients/year. The real rate growth was 3,7% for the period in the Ministry of Health's budget and 4,7% in expenses with high complexity procedures. However, when if it considers the tax calculated to each year of the period, perceives a line of decreasing trend for this tax. The number of patients under RRT was 33% higher. The average costs for patient/year varied from USD 8,500 in 2000 to USD 7,700 in 2004.

Conclusions: A meaningful increase in the national coverage of patients assisted by RRT was observed, but a reduction of the monetary values destined to this procedure. However in detriment to this fact, when the initial and final year of the research is considered, it has an increase of the geometric of the public expenses with RRT, still bigger tax of growth that the tax of growth of the budget for the health, in the same period. Deeper analyses are necessary to verify if the quality of the assistance provided and the equity in the access are guaranteed