Costs of the chain of treatment procedures in acute myocardial infarction in Brazilian reference and specialized hospitals

Objective: To present the methodology and the results of a field survey to assess the chain costs of procedures for treatment of acute myocardial infarction (AMI), carried out in 11 Brazilian reference and specialized hospitals. Methods: The cost assessment used the cost per procedure and per pathology systems. The procedures associated with the treatment of AMI were organized and their logical sequence (protocols) was used to create a flowchart. Data collection tools gathered information on prices and quantities in 2008 (private, health insurance, SUS, and Brazilian Medical Association-AMB price lists), as well as the applicable costs. Results: Overall, the total cost of the procedures involving the 'standard treatment' of AMI was R$ 12,873.69, if percutaneous coronary intervention (PCI) did not involve stent use. If the stent becomes necessary, the cost increases to Rs$ 23,461.87. Conclusion: Among the results, we emphasize the fact that the costs of the more expensive procedures did not present statistically significant variations between hospitals, regardless of their location, predominant clientele or legal nature, and the fact that hospitals that treat predominantly users of the Brazilian Unified Health System registered the lowest costs, albeit not statistically significant regarding the entire chain of procedures associated with the pathology.