The impact of health care this century

Universidade Federal de São Paulo (UNIFESP)Fleury LaboratoryUNIFESPSciEL

The importance of health economics in a world of proportionally increasing scarce resources

Universidade Federal de São Paulo (UNIFESP) Divisão de ReumatologiaUNIFESP, Divisão de ReumatologiaSciEL

Pharmacoeconomics and Outcomes Research in Latin America: A Promising and Developing Field

Universidade Federal de São Paulo, Dept Med, São Paulo, BrazilCtr Hlth Econ, São Paulo, BrazilMed Econ Brazilian Med Assoc, São Paulo, BrazilInst Clin Effectiveness & Hlth Policy, Dept Evaluac Econ & Tecnol Sanitarias, Econ Evaluat & Heath Technol Assessment Dept, Inst Efectividad Clin & Sanitaria, Buenos Aires, DF, ArgentinaUniv Buenos Aires, Serv Med Familiar & Comunitaria, Family & Community Med Div, Hosp Italiano Buenos Aires, RA-1053 Buenos Aires, DF, ArgentinaUniversidade Federal de São Paulo, Dept Med, São Paulo, BrazilWeb of Scienc

Economic impact of chronic ischemic cardiopathy treatment in Brazil: the challenge of new cardiovascular technology inclusion

Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Ministros da Saúde: pouco tempo no cargo para objetivos de longo prazo?

CONTEXT AND OBJECTIVE: Healthcare investments should consider short and long-term demands. The objectives here were to compare the average tenures of ministers of health in Brazil and in another 22 countries and to evaluate the relationship between ministers' tenures and a number of indicators. DESIGN AND SETTING: Descriptive study conducted at Centro Paulista de Economia da Saúde (CPES). METHODS: Twenty-two countries with the highest Human Development Indices (HDIs) and Brazil were included. The number of ministers over the past 20 years was investigated through each country's Ministry of Health website. Pearson's correlation coefficient was used to compare the number of ministers in each country with that country's indicators. The Mann-Whitney test was used to compare ministers' tenures in Brazil and other countries. RESULTS: The mean tenure (standard deviation, SD) of Brazilian ministers of health was 15 (12) months, a period that is statistically significantly shorter than the mean tenure of 33 (18) months in the other 22 countries (P < 0.05). There was a moderate and statistically significant positive correlation between the number of ministers and mortality rates for several conditions. The number of ministers also presented moderate and statistically significant negative correlations with per capita total healthcare expenditure (r = -0.567) and with per capita government healthcare expenditure (r = -0.530). CONCLUSION: On average, ministers of health have extremely short tenures. There is an urgent need to think and plan healthcare systems from a long-term perspective.CONTEXTO E OBJETIVO: Investimentos em saúde deveriam considerar as demandas de curto e longo prazo. Os objetivos foram comparar o tempo médio no cargo dos ministros da saúde no Brasil e em outros 22 países e avaliar a relação entre o tempo médio dos ministros no cargo e alguns indicadores. TIPO DE ESTUDO E LOCAL: Estudo descritivo realizado no Centro Paulista de Economia da Saúde (CPES). MÉTODOS: Vinte e dois países com os Índices de Desenvolvimento Humano (IDHs) mais altos e o Brasil foram incluídos. O número de ministros da saúde nos últimos 20 anos foi pesquisado na página eletrônica do Ministério da Saúde de cada país. Coeficiente de correlação de Pearson (CCP) foi utilizado para comparar o número de ministros em cada país com os indicadores daquele país. O teste de Mann-Whitney foi usado para comparar o tempo de permanência do ministro da saúde no Brasil com os outros países. RESULTADOS: O tempo médio (desvio padrão, DP) no cargo dos ministros brasileiros foi de 15 (12) meses, um período estatisticamente significante menor do que a média observada nos outros 22 países, 33 (18) meses (P < 0,05). Foi observada uma moderada e também estatisticamente significante correlação positiva entre o número de ministros e taxas de mortalidade para várias condições. Houve uma moderada e significante correlação negativa entre o número de ministros e o investimento em saúde per capita total (r = -0.567) e o investimento em saúde público per capita (r = -0.530). CONCLUSÃO: O ministro da saúde permanece, na média, pouco tempo no cargo. Há uma premente necessidade de se pensar e planejar o sistema de saúde para o longo prazo.Universidade Federal de São Paulo (UNIFESP) Centro Paulista de Economia da SaúdeUniversidade Federal de São Paulo (UNIFESP) School of MedicineUNIFESP, Centro Paulista de Economia da SaúdeUNIFESP, School of MedicineSciEL

Health technology assessment: the process in Brazil

Objectives. To describe, analyze, and compare the opinions of decision makers involved in the health technology assessment (HTA) process in Brazil in 2011. Methods. A cross-sectional study was conducted using a structured questionnaire to evaluate the opinions of a convenience sample of health care professionals from both the public and private health care systems (HCS). The survey collected demographic data for each respondent along with their input on national regulations. Data analysis included descriptive statistics, including chi-square tests to compare groups. Results. Of the 200 completed questionnaires, 65% of the respondents were 31-50 years of age36% were HCS managers, 49.3% from the public and 50.7% from the private system. The majority of respondents (85%) considered the time permitted for submission of new technology to be inadequate88% also stated that the composition of the evaluation committee needed improvement. Respondents from the private health system more frequently stated that submission times were inappropriate (P = 0.019) and that the deadline for a decision by the committee should be defined (P = 0.021), with a maximum of no more than 180 days / 6 months (P < 0.001). Conclusions. Respondents indicated that the HTA process should be improved to meet their expectations. Given that new legislation has been enacted to continuously accept submissions, to make decisions within 180 days, and to expand the committee to represent more stakeholders, most of the respondents concerns have been addressed. This study is valuable as an historical analysis of HTA process improvement. Further surveys are needed to track the new HTA process, its application, and its contribution to health care needs in Brazil.Univ Fed Sao Paulo, Div Hlth Econ & Healthcare Management, Dept Med, Sao Paulo, BrazilDivision of Health Economics and Healthcare Management, Department of Medicine, Universidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc