RESUMO
Objetivo: Estimar as perdas de produtividade causadas pela doença pulmonar obstrutiva crônica (DPOC) na população brasileira. Métodos: O estudo utilizou dados obtidos do Datasus, IBGE, indicadores previdenciários, óbitos e aposentadorias precoces por DPOC no Brasil de 2017 a 2022. Para estimar o impacto da DPOC, foram utilizados: anos de vida saudável perdidos (DALYs) e anos de vida ajustados por produtividade (PALYs), assim como as métricas de perda de produtividade salarial (PPS) e perda de produtividade nacionalizada (PPN), que avalia a perda em função do PIB. Resultados: Mais de 196 milhões de dias de trabalho foram perdidos devido à DPOC. As principais fontes são: óbitos precoces (95.264.088), afastamentos permanentes (67.314.232) e aposentadoria precoce (30.304.490). Diárias hospitalares (3.221.591) têm uma contribuição minoritária. O valor total de DALYs observado no período do estudo foi de 2.819.332,63 anos de vida saudável perdidos causados pela DPOC; um total de 14.997.166 PALYs foi perdido por conta da DPOC ou um valor anual equivalente de R$ 230,7 bilhões. Considerando a PPS, estimamos que a DPOC acarretou perdas de produtividade associadas à reposição da mão de obra de R$ 1,38 bilhão anual e, em relação à PPN, de R$ 8,28 bilhões por ano. Conclusões: Afastamentos de pacientes com DPOC podem acarretar maiores dispêndios com pagamentos de benefícios previdenciários. Este estudo atualiza e amplia correlações entre dados socioepidemiológicos, custos de saúde e previdenciários da DPOC no Brasil. Considerando todas as perdas, a DPOC pode causar perdas de R$ 240 bilhões por ano.
Objective: To estimate productivity losses due to workdays lost caused by chronic obstructive pulmonary disease (COPD) in the Brazilian population. Methods: The study used data from DATASUS, IBGE, social security indicators, deaths, and early retirements due to COPD in Brazil from 2017 to 2022. To estimate the impact of COPD, the following were used: Disability-Adjusted Life Years (DALYs) and Productivity-Adjusted Life Years (PALYs), as well as metrics for wage productivity loss (PPS) and nationalized productivity loss (PPN), which evaluates the loss in relation to GDP. Results: More than 196 million workdays were lost due to COPD. The main sources are premature deaths (95,264,088), permanent absences (67,314,232), and early retirement (30,304,490). Hospitalization days (3,221,591) had a minor contribution. The total DALYs observed during the study period was 2,819,332.63 years of healthy life lost due to COPD; a total of 14,997,166 PALYs were lost due to COPD, equivalent to an annual value of R$ 230.7 billion. Considering PPS, we estimate that COPD resulted in productivity losses associated with workforce replacement of R$ 1.38 billion annually; and in relation to PPN, R$ 8.28 billion per year. Conclusions: Absences in COPD patients can lead to higher expenditures on social security benefit payments. This is the first study to correlate socioepidemiological data, health, and social security costs of COPD in Brazil. Considering all losses, COPD can cause losses of R$ 240 billion per year.
RESUMO
Objetivo: Estimar os principais custos indiretos da insuficiência cardíaca (IC) na população brasileira, sobre o sistema de saúde, o custo previdenciário e o quanto se perde em produtividade pelas complicações da doença. Métodos: Estudo ecológico desenvolvido com dados secundários, para a série histórica de 2018 a 2021, minerados do Departamento de Informática do Sistema Único de Saúde (Datasus), do Instituto Brasileiro de Geografia e Estatística (IBGE), e indicadores previdenciários coletados da Previdência Social e Instituto Nacional do Seguro Social (INSS). Resultados: Foram registrados 77.290 óbitos por IC no Brasil para o período, distribuídos uniformemente em relação ao sexo. A taxa de mortalidade foi diversificada entre as regiões brasileiras, com ênfase para Sudeste e Nordeste. As projeções indicam um gasto total de mais de R$ 1 bilhão com hospitalizações, com custo médio hospitalar de R$ 1.725,27 por pessoa. O custo médio por internação ultrapassou os R$ 2 bilhões de reais. Aproximadamente 3% das despesas federais são destinadas a pagamentos de benefícios relacionados a IC. Do total de afastamentos, 65% correspondem a homens e 35%, a mulheres, com custos que podem chegar a R$ 6 bilhões perdidos por ano. Conclusão: Os resultados sugerem um aumento do afastamento de portadores de IC da força de trabalho, o que acarreta maiores dispêndios para o sistema de saúde e pagamentos de benefícios previdenciários, como auxílio-doença e aposentadoria por incapacidade de longa duração. Este é o primeiro estudo que estima e correlaciona os dados socioepidemiológicos e os custos de saúde e previdenciários da IC no Brasil.
Objective: To estimate the main indirect costs of heart failure (HF) in the Brazilian population, on the health system, social security cost, and how much is lost in productivity due to the complications of the disease. Methods: Ecological study developed with secondary data, for the historical series from 2018 to 2021, mined from the Department of Informatics of the Unified Health System (Datasus), from the Brazilian Institute of Geography and Statistics (IBGE), and social security indicators collected from Social Security and the National Social Security Institute (INSS). Results: There were 77,290 deaths from HF in Brazil for the period, evenly distributed according to sex. The mortality rate was diversified among Brazilian regions, with emphasis on the Southeast and Northeast. Projections indicate a total expenditure of more than BRL 1 billion with hospitalizations, with an average hospital cost of BRL 1,725.27 per person. The average cost per hospitalization exceeded BRL 2 billion. Approximately 3% of federal expenditures are earmarked for IC benefit payments. Of the total number of absences, 65% correspond to men and 35% to women, with costs that can reach R$ 6 billion lost per year. Conclusion: The results suggest an increase in the removal of HF patients from the workforce, which leads to higher expenditures for the health system and payments of social security benefits, such as sick pay and retirement due to long-term disability. This is the first study that estimates and correlates socio-epidemiological data, health and social security costs of HF in Brazil.
Assuntos
Custos e Análise de Custo , Big Data , Insuficiência CardíacaRESUMO
RT-qPCR is the gold standard technique available for SARS-CoV-2 detection. However, the long test run time and costs associated with this type of molecular testing are a challenge in a pandemic scenario. Due to high testing demand, especially for monitoring highly vaccinated populations facing the emergence of new SARS-CoV-2 variants, strategies that allow the increase in testing capacity and cost savings are needed. We evaluated a RT-qPCR pooling strategy either as a simplex and multiplex assay, as well as performed in-silico statistical modeling analysis validated with specimen samples obtained from a mass testing program of Industry Federation of the State of Rio de Janeiro (Brazil). Although the sensitivity reduction in samples pooled with 32 individuals in a simplex assay was observed, the high-test sensitivity was maintained even when 16 and 8 samples were pooled. This data was validated with the results obtained in our mass testing program with a cost saving of 51.5% already considering the expenditures with pool sampling that were analyzed individually. We also demonstrated that the pooling approach using 4 or 8 samples tested with a triplex combination in RT-qPCR is feasible to be applied without sensitivity loss, mainly combining Nucleocapsid (N) and Envelope (E) gene targets. Our data shows that the combination of pooling in a RT-qPCR multiplex assay could strongly contribute to mass testing programs with high-cost savings and low-reagent consumption while maintaining test sensitivity. In addition, the test capacity is predicted to be considerably increased which is fundamental for the control of the virus spread in the actual pandemic scenario.