COSTS FOR THE SURGICAL TREATMENT OF OBESITY THROUGH LAPAROSCOPY IN A FEDERAL TERTIARY HOSPITAL BY THE BRAZILIAN UNIFIED HEALTH SYSTEM.

Álvaro Antonio Bandeira Ferraz, Hiago Dantas Medeiros, Fernando Santa-Cruz, Flávio Kreimer
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Abstract

Background: Obesity is a multifactorial disease affecting a significant portion of the population. Bariatric surgery emerges as a prominent approach in this context, representing an effective treatment both in the short and long term. The costs associated with bariatric surgery vary depending on the characteristics of the patients, current hospital practices, and available funding sources.

Aims: To analyze the costs of minimally invasive bariatric surgery for the treatment of obesity in a tertiary federal public hospital.

Methods: An observational and descriptive study aimed at assessing the costs associated with laparoscopic vertical gastrectomy (GV) and Roux-en-Y gastric bypass (RYGB) in a federal public tertiary service from 2018 to 2021. Data were obtained through the management of medical-hospital expenses related to surgical and anesthetic supplies, as well as the amount reimbursed by the funding source to the hospital.

Results: Over the analyzed period, a total of 177 minimally invasive bariatric surgeries were performed. In terms of the charges, since 2018, the hospital has been receiving an amount of R$ 6,145.00 for the "bariatric surgery by videolaparoscopy" procedure, which includes RYGB, and R$ 4,095.00 for "vertical gastrectomy." Regarding the average hospital cost of surgical supplies, RYGB incurred a total of R$ 9,907.54, while GV incurred a total of R$ 9,315.84. The average total cost of RYGB was R$ 10,799.23, and, for GV, it was R$ 10,207.53. These figures indicate that the hospital incurred a loss of approximately R$ 4,654.23 for performing RYGB and R$ 6,112.53 for GV.

Conclusion: Despite the increasing number of eligible patients for surgical treatment of obesity and the consequent quantitative growth of these procedures funded by the Brazilian Unified Health System (SUS), the costs exceed the reimbursement from the funding source in federal public hospitals. There is a need for a precise assessment of financing in the fight against obesity.

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巴西统一卫生系统在联邦三级医院通过腹腔镜手术治疗肥胖症的费用。
背景:肥胖是一种影响很大一部分人群的多因素疾病。在这种情况下,减肥手术作为一种突出的方法出现,代表了短期和长期有效的治疗方法。与减肥手术相关的费用取决于患者的特点、目前医院的做法和可用的资金来源。目的:分析某三级联邦公立医院采用微创减肥手术治疗肥胖症的费用。方法:一项观察性和描述性研究,旨在评估2018年至2021年联邦公共三级服务中腹腔镜垂直胃切除术(GV)和Roux-en-Y胃旁路术(RYGB)的相关成本。数据是通过管理与手术和麻醉用品有关的医疗医院费用以及资金来源向医院偿还的金额获得的。结果:在分析期内,共进行了177例微创减肥手术。在费用方面,自2018年以来,该医院已经收到了6145雷亚尔的“视频腹腔镜减肥手术”费用,其中包括RYGB,以及4095雷亚尔的“垂直胃切除术”费用。关于手术用品的平均医院费用,RYGB总共花费9,907.54雷亚尔,而GV总共花费9,315.84雷亚尔。RYGB的平均总成本为10,799.23雷亚尔,GV的平均总成本为10,207.53雷亚尔。这些数字表明,医院因实施RYGB而损失约4 654.23雷亚尔,因实施GV而损失约6 112.53雷亚尔。结论:尽管巴西统一卫生系统(SUS)资助的肥胖手术治疗的合格患者数量不断增加,这些手术的数量也随之增加,但其费用超过了联邦公立医院资金来源的报销。有必要对抗击肥胖的资金进行精确评估。
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CHROMOPHOBE HEPATOCELLULAR CARCINOMA: DIAGNOSTIC CHALLENGES. COMPLICATIONS AFTER HEPATECTOMY. EARLY REFEEDING AFTER COLORECTAL CANCER SURGERY REDUCES COMPLICATIONS AND LENGTH OF HOSPITAL STAY. MANAGEMENT OF SYNCHRONIC LARGE LIVER METASTASIS IN A NON-OCCLUSIVE COLON TUMOR. HETEROTOPIC GASTRIC MUCOSA OF THE ESOPHAGUS AS A POTENTIAL CAUSE OF PEPTIC STENOSIS AFTER ROUX-EN-Y GASTRIC BYPASS.
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