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Costs of pediatric hydrocephalus treatment for the Brazilian public health system in the Northeast of Brazil

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Abstract

Purpose

To estimate the costs of the surgical treatment of pediatric hydrocephalus, specifically ventriculoperitoneal shunt (VPS) and endoscopic third ventriculostomy (ETV), for the Brazilian public health system (SUS).

Methods

Retrospective cohort study of health records of patients < 14 years of age with a diagnosis of hydrocephalus who underwent VPS or ETV between September 2009 and June 2016, regularly followed up for 24 months.

Results

Seventy-six medical records were included. The groups of children who underwent VPS and ETV consisted of 60 and 16 patients, respectively. Complications during 2 years of follow-up were identified in 56% of the children undergoing VPS and in 18% of those undergoing ETV (p = 0.0103). The initial cost of VPS was lower than that of ETV up to approximately 1 year of post-surgical follow-up. After that, VPS generated higher expenses for the SUS due to higher rates of late post-surgical complications and repeated readmissions.

Conclusion

Higher public expenditures were observed in the group of children undergoing VPS due to higher rates of infectious and mechanical complications requiring repeated hospitalizations and prosthesis replacements. Public policies must be tailored to offer the best treatment to children with hydrocephalus and to make judicious use of public resources without compromising the quality of treatment.

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Acknowledgements

The authors acknowledge the administrative team of the Martagão Gesteira Hospital for providing the necessary data to carry out this research.

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Authors and Affiliations

  1. Martagão Gesteira Hospital, Salvador da Bahia, Brazil

    Luan Guanais Soriano

  2. São Rafael Hospital, Rede D’Or, Salvador da Bahia, Brazil

    José Roberto Tude Melo

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  1. Luan Guanais Soriano
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Correspondence to José Roberto Tude Melo.

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The research was presented by Luan Guanais Soriano at the conclusion of the medical residency course in pediatrics at the Martagão Gesteira Hospital (Salvador da Bahia, Brazil), supervised by José Roberto Tude Melo, awarded with the Professor Nelson Barros Prize in 2018 from the Pediatrics Society of Bahia.

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Soriano, L.G., Melo, J.R.T. Costs of pediatric hydrocephalus treatment for the Brazilian public health system in the Northeast of Brazil. Childs Nerv Syst 38, 2149–2154 (2022). https://doi.org/10.1007/s00381-022-05630-4

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