Study of costs of admissions for ischemic heart disease in individuals with and without diabetes mellitus in cardiac reference center brazilian Unified Health System

Abstract

Objectives: Estimate the direct costs in hospital admissions due to ischemic heart disease in two patients groups: with diabetes mellitus (DM) and without diabetes mellitus (NDM). Verify which factors are most relevant for the cost in each group. Methods: Retrospective cohort with 421 patient between January 2009 and March 2010. We evaluated the clinical treatments, hemodynamic interventions and surgeries. Costs were obtained from three sources: Procedures Table Management System, Drugs and Orthosis, Prosthesis and Material Unified Health System – SIGTAP; invoiced by the hospital and active search for resources used by the patient called ‘hospitalization costs’. The groups were compared using the Mann-Whitney test; p < 0.05 was considered statistically significant; analyzes conducted on R version 3.1.0 program. Results: We evaluated 421 patients, 45.4% were diabetic heart disease (DM). There were no statistically significant differences in the cost values between the groups. We verified that the relevant factors for higher costs are materials and drugs (DM = 41,9%; NDM = 48,4%) on surgical patients; hemodyalisis procedure for DM group (69,8%) and professional costs for NDM group (50,6%) on clinical treatment patients; secondary procedures for DM group (48,8%) and professional costs for NDM group (75,6%) on hemodynamic interventions patients. Conclusion: There was no differential financial impact attributable to diabetes in hospital cardiac patients. Professional services, material and drugs, hemodyalisis and secondary procedures are the most relevant for higher cost on analysed groups.