The proposition of a bundled reimbursement strategy for the COVID-19 treatment in Brazil
Atualizado: 20 de ago. de 2021
Principal researchers: Carisi Anne Polanczyk, Ana Paula Beck da Silva Etges, Milena Soriano Marcolino, Karen Brasil Ruschel and Richard Urman.
The resources are finite and, therefore, the health system needs to operate with efficiency to deliver care to the population without causing a collapse. The disease caused by SARS-COV-2 (COVID-19) evidenced the constant relationship between health and economy and so that, over time, health care remains sustainably, it is necessary to comprehend the cost that hospital treatment represents for institutions. The disease caused by SARS-COV-2 (COVID-19) evidenced the constant relationship between health and economy and so that, over time, health care remains sustainably, it is necessary to comprehend the cost that hospital treatment represents to the system. Based on that information, reimbursement strategies that reflect the Brazilian reality can be introduced with better precision. As a continuation of the project “Hospital register of patients with the disease caused by SARS-COV-2 (COVID-19)”, this study aims to generate real hospital cost information of patients with COVID-19 to scientifically subsidize reimbursement strategies in a bundled format from the perspective of public and supplementary health systems in Brazil. The study contemplates the analysis of real costs by microcosting technique to create a reference for cost information considering the comorbidities and clinical complexity of the patients. Resource consumption data will be analyzed by patients hospitalized with COVID-19 in hospitals participating in the hospital registry project. Data from clinical registers and administrative systems will be extracted from each institution guided by a standard form to sustain the future data analysis. Financial and institutional data will also be collected through a standard questionnaire to the institutions. The union of the databases of the clinical, financial, and resource consumption records per patient will form the datasheet for the real hospital costs analysis in Brazil. Descriptive statistical analyzes and comparisons between groups using multivariate data analysis will be used to identify hospital cost reference information. Additionally, the Diagnosis-related groups (DRG) established for the treatment of SARS will be used to classify patients in terms of risk and resource consumption for proposing a reimbursement bundled for COVID-19 in Brazil. The definition of bundles by DRG classification will contemplate the expectation of clinical and process outcomes. Remuneration bands will be assigned for each level of patient classification and expected performance in clinical and process outcomes. At the same time, the literature proposing reimbursement models for the treatment of COVID-19 will be continuously monitored, so that the Brazilian model resembles that of other countries. A Business Intelligence platform will be developed to provide accessibility of information to the population and health managers, and the data collection guidance protocol for cost analysis will be made available online for use in multiple centers in the country. In addition to the products delivered, the information generated by the study will be documented in scientific articles, allowing Brazilian COVID-19 cost and reimbursement information to be consulted internationally, guiding sustainable economic management strategies for the treatment of COVID-19 in multiple countries.