einstein (São Paulo). 01/Apr/2017;15(2):212-9.

Hospitalization costs of severe bacterial pneumonia in children: comparative analysis considering different costing methods

Sheila Elke Araujo Nunes, Ruth Minamisava, Maria Aparecida da Silva Vieira, Alexander Itria, Vicente Porfirio Pessoa Junior, Ana Lúcia Sampaio Sgambatti de Andrade, Cristiana Maria Toscano

DOI: 10.1590/S1679-45082017GS3855

ABSTRACT

Objective

To determine and compare hospitalization costs of bacterial community-acquired pneumonia cases via different costing methods under the Brazilian Public Unified Health System perspective.

Methods

Cost-of-illness study based on primary data collected from a sample of 59 children aged between 28 days and 35 months and hospitalized due to bacterial pneumonia. Direct medical and non-medical costs were considered and three costing methods employed: micro-costing based on medical record review, micro-costing based on therapeutic guidelines and gross-costing based on the Brazilian Public Unified Health System reimbursement rates. Costs estimates obtained via different methods were compared using the Friedman test.

Results

Cost estimates of inpatient cases of severe pneumonia amounted to R$ 780,70/$Int. 858.7 (medical record review), R$ 641,90/$Int. 706.90 (therapeutic guidelines) and R$ 594,80/$Int. 654.28 (Brazilian Public Unified Health System reimbursement rates). Costs estimated via micro-costing (medical record review or therapeutic guidelines) did not differ significantly (p=0.405), while estimates based on reimbursement rates were significantly lower compared to estimates based on therapeutic guidelines (p<0.001) or record review (p=0.006).

Conclusion

Brazilian Public Unified Health System costs estimated via different costing methods differ significantly, with gross-costing yielding lower cost estimates. Given costs estimated by different micro-costing methods are similar and costing methods based on therapeutic guidelines are easier to apply and less expensive, this method may be a valuable alternative for estimation of hospitalization costs of bacterial community-acquired pneumonia in children.

Hospitalization costs of severe bacterial pneumonia in children: comparative analysis considering different costing methods

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