Estudo de custos de casos suspeitos de Dengue em uma amostra ambulatorial atendida nos sistemas de saúde público e privado do Rio de Janeiro

Abstract

Dengue outbreaks imposes a huge burden on the population, on health systems and the economy of most tropical countries of the world. The aim of this study was to describe the direct and indirect costs of outpatient treatment of dengue cases in the city of Rio de Janeiro. We recruited suspected dengue patients treated between September 2012 and August 2013, at hospital and ambulatory settings in public and private health systems. Data collection was performed by recruiting on the health care facility and we conducted a household interview during the period of convalescence (15 - 30 days after onset of symptoms). We collected data regarding the episode of dengue and its resolution; use of medical services (medical appointments, drugs, laboratory tests); absence from work and school; family expenses (expenses out-of-pocket) to calculate the direct and indirect costs. The measurement of costs was made by micro-costing approach and the valuation by specific sources for public or private services. The costs of outpatient cases were calculated as the sum of all components of direct medical costs, non-medical costs and indirect costs. The mean and standard deviation (SD) for normally distributed variables were calculated. The total cost per outpatient case in the public sector was estimated in R$ 138.81 (SD ± 120.81) and the private sector in R$ 496.46 (SD ± 787.18). Making an extrapolation of the studied sample, for reported cases in SINAN in the same period of the study, outpatient care for suspected dengue cases in the city of Rio de Janeiro would amount R$ 6,458,305.16 in the public sector, and R$ 11,120,976 45 in the private sector. In order to achieve better understanding of the economic impact of dengue for the population of Rio de Janeiro and health systems, more research needs to be developed using methodologies that include vector control costs, educational campaigns and surveillance activities, and thus base the directions needed to reduce the number of dengue cases.