Loading...
Publication
Análise de Custos do Seguimento de Pacemakers:Comparação entre Modalidade Presencial e à Distância em Beneficiários de Transporte Não Urgente numa Unidade Local de Saúde E.P.E
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.3 MB | Adobe PDF |
Advisor(s)
Abstract(s)
A saúde digital contribui para a democratização dos cuidados em contexto ético, seguro e sustentável. A monitorização remota permite o seguimento à distância de dispositivos cardíacos implantáveis. Os utentes com pacemakers anti bradicardia são o maior grupo e, simultaneamente, com menor acesso a esta tecnologia, pela controversa relação custo-benefício, sendo o custo dos equipamentos e adaptação das organizações e recursos, barreiras à implementação alargada. Em oposição, o transporte comparticipado ascendeu, só em 2023 em Portugal, a aproximadamente 81 milhões de euros. Pretendeu-se aferir a viabilidade financeira do seguimento à distância de utentes com pacemaker, numa unidade local de saúde, contrapondo os custos do transporte não urgente comparticipado, com o investimento nos equipamentos da consulta remota, e aferir a satisfação e aceitação deste seguimento. Realizaram-se 41 questionários a utentes/familiares da consulta de pacemaker com transporte comparticipado.
Projetaram-se custos entre o protocolo presencial a cada 6 meses, e outro protocolo com consulta presencial a cada 2 anos e à distância a cada 6 meses, durante a longevidade expectável dos dispositivos. Com uma redução de visitas presencias prevista de 74%, o seguimento à distância permitiria poupanças globais de 373
euros/doente (21.2%) com a comparticipação máxima (p=0.01151). As poupanças ascendem até aos 33.3% correspondendo a 764 euros/doente (p=0.0002742) para distâncias > 60km (ida e volta) em utentes com comparticipação máxima que recorrem a ambulância. O seguimento à distância de pacemakers pode assim ser uma alternativa financeiramente viável com elevada aceitação e satisfação (88%).
Digital technologies can contribute to healthcare democratization in an ethical, safe and sustainable context. The remote monitoring of implantable cardiac devices enables the follow-up of patients from a distance. Patients with anti-bradycardia pacemakers represent the largest group and have the least access to this technology, due to the controversial cost-benefit ratio and barriers to its widespread implementation, such as equipment costs and organizations challenges. In contrast, reimbursed transportation in Portugal reached approximately 81 million euros, in just 2023. The main goal was to assess the financial viability of remote pacemaker follow-up at a local health unit, comparing the non-urgent transportation costs and the investment in remote monitoring equipment, while measuring the user acceptance and satisfaction. A total of 41 surveys were conducted with patients and family members who had received a pacemaker and who had been reimbursed for their transportation costs. The projected costs were calculated for two protocols: the first entailed in-person visits every six months, while the second involved in-person visits every two years with remote consultations every six months, over the expected lifespan of the devices. The expected overall reduction in face-to-face visits was 74%. The implementation of remote follow-up would result in a cost saving of €373 per patient (21.2%), with total reimbursement (p=0.01151). The savings increase to 33.3%, reaching 764 euros/patient (p=0.0002742) for distances greater than 60 km (round trip) for ambulance users with total reimbursement. Remote monitoring of pacemakers can be a financially viable alternative with high acceptance and satisfaction (88%).
Digital technologies can contribute to healthcare democratization in an ethical, safe and sustainable context. The remote monitoring of implantable cardiac devices enables the follow-up of patients from a distance. Patients with anti-bradycardia pacemakers represent the largest group and have the least access to this technology, due to the controversial cost-benefit ratio and barriers to its widespread implementation, such as equipment costs and organizations challenges. In contrast, reimbursed transportation in Portugal reached approximately 81 million euros, in just 2023. The main goal was to assess the financial viability of remote pacemaker follow-up at a local health unit, comparing the non-urgent transportation costs and the investment in remote monitoring equipment, while measuring the user acceptance and satisfaction. A total of 41 surveys were conducted with patients and family members who had received a pacemaker and who had been reimbursed for their transportation costs. The projected costs were calculated for two protocols: the first entailed in-person visits every six months, while the second involved in-person visits every two years with remote consultations every six months, over the expected lifespan of the devices. The expected overall reduction in face-to-face visits was 74%. The implementation of remote follow-up would result in a cost saving of €373 per patient (21.2%), with total reimbursement (p=0.01151). The savings increase to 33.3%, reaching 764 euros/patient (p=0.0002742) for distances greater than 60 km (round trip) for ambulance users with total reimbursement. Remote monitoring of pacemakers can be a financially viable alternative with high acceptance and satisfaction (88%).
Description
Dissertação, Mestrado, Gestão de Unidades de Saúde, Instituto Politécnico de Santarém, Escola Superior de Gestão e Tecnologia, 2024
Keywords
Unidade Local de Saúde Monitorização remota Pacemakers Serviço Nacional de Saúde Transporte não urgente de doentes Local Health Unit Remote monitoring National Health Service
Citation
Oliveira, J. (2025). Análise de Custos do Seguimento de Pacemakers: Comparação entre Modalidade Presencial e à Distância em Beneficiários de Transporte Não Urgente numa Unidade Local de Saúde E.P.E. (Mestrado). Escola Superior de Gestão e Tecnologia, Santarém. Disponível na WWW em:<http://hdl.handle.net/10400.15/5689>