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Doctoral Thesis
DOI
https://doi.org/10.11606/T.96.2020.tde-05052020-104400
Document
Author
Full name
Renato Mantelli Picoli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Costa, André Lucirton (President)
Coelho, Eduardo Barbosa
Gremaud, Amaury Patrick
Itria, Alexander
Nunes, Altacilio Aparecido
Ungari, Andrea Queiróz
Title in Portuguese
Avaliação econômica do programa de automonitoramento de glicemia capilar em pacientes com diabetes na perspectiva da Secretaria de Saúde do município de Ribeirão Preto - SP
Keywords in Portuguese
Análise de custo-efetividade
Automonitoramento de glicemia capilar
Diabetes mellitus
Abstract in Portuguese
O diabetes é uma doença crônica não transmissível, caracterizada pelo aumento dos níveis glicêmicos no sangue, podendo levar a complicações micro e macrovasculares. Para o sucesso no controle do DM são necessárias estratégias de educação em saúde, automonitoramento e tratamento farmacológico. Assim, este estudo tem como objetivo avaliar a razão de custo efetividade do programa de automonitoramento de glicemia capilar em pacientes com diabetes sob a perspectiva da secretaria municipal de saúde do município de Ribeirão Preto - SP. A pesquisa foi definida como um estudo observacional, onde indivíduos foram avaliados pré e pós intervenção, atuando como autocontrole. No período pré as proporções de pacientes que atingiram a meta de controle metabólico para desfecho HbA1c, para população geral, DMT1 e DMT2 foram 15,59%, 28,26% e 14,25% respectivamente. Após 6 meses da inclusão as proporções foram de 32,59%, 45,09% e 30,51%. A probabilidade de um paciente na população geral atingir a meta de controle glicêmico é de 1,95 (IC95% 1,54 - 2,46) vezes maior se o paciente for incluído no PAMGC do que se não for exposto ao programa. Para a população DMT2, o risco relativo foi de 2,13 (IC 95% 1,64 - 2,76). Assim, a razão de custo efetividade incremental foi de 1.229,30 reais por paciente controlado na população geral e de 1.159,89 reais por paciente controlado na população DMT2. Com isso, o PAMGC apresentou resultado incremental de efetividade associado a um gasto incremental com recursos em saúde.
Title in English
Economic evaluation of self-monitoring blood glucose program in patients with diabetes from the perspective of the Health Department of Ribeirão Preto-SP
Keywords in English
Cost-effectiveness analysis
Diabetes mellitus
Self-monitoring blood glucose
Abstract in English
Diabetes is a chronic noncommunicable disease characterized by increased blood glucose levels, which can lead to micro to macrovascular complications. Successful DM control requires health education strategies, self-monitoring and pharmacological treatment. Thus, this study aims to evaluate the cost-effectiveness ratio of the self-monitoring blood glucose program in patients with diabetes from the perspective of the municipal health department of Ribeirão Preto - SP. The research was defined as a retrospective observational study, where individuals were evaluated before and after intervention, acting as self-control. In the pre-period, the proportions of patients who achieved the metabolic control goal for outcome HbA1c for the general population, T1DM and T2DM were 15.59%, 28.26% and 14.25% respectively. Six months after inclusion, the proportions were 32.59%, 45.09% and 30.51%. The risk of a patient in the general population achieving the glycemic control goal is 1.95 (95% CI 1.54 - 2.46) times higher if the patient is included in the PAMGC than if not exposed to the program. For the T2DM population, the relative risk was 2.13 (95% CI 1.64 - 2.76). Thus, the incremental cost effectiveness ratio was R$ 1,229.30 per controlled patient in the general population and R$ 1,159.89 per controlled patient in the T2DM population. Thus, the PAMGC corresponds to an incremental effectiveness associated with an incremental expenditure on health resources.
 
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Publishing Date
2020-07-09
 
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