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Health care costs in the last four years of life for private health plan beneficiaries in Brazil

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Date
2008
Author
Ferraz, Marcos Bosi
Miranda, Isaura Cristina
Padovan, Jorge
Soárez, Patricia Coelho de
Ciconelli, Rozana
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Abstract
OBJECTIVE: To examine health care use and expenditures by Brazilians covered by private health care plans in the last four years of life. METHODS: Health plan provider enrollee files and death certificate data were used for 274 health plan beneficiaries who died in 1998, 1999, and 2000. Resources used for a beneficiary in the year of death and in the three years prior to death were identified. Descriptive statistical analyses were used for clinical and socio-demographic characteristics and to describe the costs. RESULTS: Of the 274 deaths included in this analysis, 92 occurred in 1998, 82 in 1999, and 100 in 2000. Most of the deceased were males (61.4 percent). Distribution in terms of type of health plan coverage (full versus hospitalization-only coverage) was similar among beneficiaries (53 percent had hospitalization only and 47 percent had full coverage). The total health plan expenditure in the last four years of life for the 274 decedents was US$ 26 300 283 (US$ 12 287 723 for beneficiaries with hospitalization-only and US$ 14 012 560 for those with full coverage). Expenditures increased progressively in the four years preceding death. About 70 percent of medical expenses for decedents in the four years of this analysis were incurred in the last year of life. CONCLUSION: Relatively large amounts of health care resources are used by Brazilian private health plan participants in their last year of life, suggesting that specific strategies are needed to optimize the allocation of medical care resources for these patients.(AU)
 
OBJETIVO: Examinar la utilización de los servicios de salud y los gastos asociados durante los últimos cuatro años de vida de brasileños con seguro privado de salud. MÉTODOS: Se emplearon los expedientes del seguro y los certificados de defunción de 274 beneficiarios de seguros de salud que murieron entre 1998 y 2000. Se identificaron los recursos utilizados para cada beneficiario durante el año que murió y los tres años anteriores. Mediante métodos estadísticos descriptivos se analizaron las características clínicas y sociodemográficas y se describieron los costos. RESULTADOS: De los 274 fallecidos analizados, 92 murieron en 1998, 82 en 1999 y 100 en 2000; la mayoría de ellos (61,4 por ciento) eran hombres. La distribución según el tipo de seguro de salud fue similar (cobertura total: 47 por ciento; solo cobertura de hospitalización: 53 por ciento). El gasto total del seguro de salud en los últimos cuatro años de vida de los 274 fallecidos fue de US$ 26 300 283 (US$ 12 287 723 para los beneficiarios con cobertura de hospitalización solamente y US$ 14 012 560 para los que tenían cobertura total). Los gastos aumentaron progresivamente en los cuatro años previos a la muerte. Cerca de 70 por ciento de los gastos médicos de los fallecidos en los cuatro años analizados correspondieron al último año de vida. CONCLUSIONES: Los brasileños con seguro médico privado utilizan una cantidad relativamente grande de recursos sanitarios en su último año de vida, por lo que se requieren estrategias específicas para optimizar la asignación de recursos de atención médica para estos pacientes.(AU)
 
Series
Rev Panam Salud Publica;24(2),ago.2008
Subject
Death; Health Care Costs; Insurance, health; Terminal care; Brazil; Muerte; Costos de la atención en salud; Seguro de salud; Cuidado terminal; Brasil; Custos de Cuidados de Saúde; Seguro Saúde; Assistência Terminal; Brasil; Setor Privado; Fatores de Tempo; Adulto Jovem
URI
http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892008000800006
https://iris.paho.org/handle/10665.2/9943
Citation
Ferraz, Marcos Bosi,Miranda, Isaura Cristina,Padovan, Jorge,Soárez, Patricia Coelho de,Ciconelli, Rozana (2008) Health care costs in the last four years of life for private health plan beneficiaries in Brazil. Rev Panam Salud Publica;24(2) 120-126,ago.2008. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892008000800006
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  • Pan American Journal of Public Health

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