03045nas a2200385   4500000000100000008004100001653002600042653001800068653003300086653001600119653000900135653001100144653002000155653002200175653001100197653002200208653001100230653002800241653002800269653002800297653001100325653000900336100002200345700001500367700001200382700001500394700001200409700001500421245012000436856009000556300001000646490000600656520198300662022001402645       2014                            d10aRetrospective Studies10aPublic health10aPractice Guidelines as Topic10aMiddle Aged10aMale10aHumans10aHospitalization10aHealth Care Costs10aFemale10aDisease Outbreaks10aDengue10aDelivery of Health Care10aCross-Sectional Studies10aCosts and Cost Analysis10aBrazil10aAged1 aVieira Machado AA1 aEstevan AO1 aSales A1 aBrabes KCS1 aCroda J1 aNegrão FJ00aDirect costs of dengue hospitalization in Brazil: public and private health care systems and use of WHO guidelines.  uhttp://journals.plos.org/plosntds/article/asset?id=10.1371%2Fjournal.pntd.0003104.PDF  ae31040 v83 a<p><strong>BACKGROUND: </strong>Dengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed.</p>

<p><strong>METHODS AND RESULTS: </strong>To analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO) guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5% of the gross domestic product per capita in Dourados that year. In 35.2% of cases, blood products were used in patients who did not meet the blood transfusion criteria. The overall median hospitalization cost was higher (p = 0.002) in the group that received blood products (US $1,622.40) compared with the group that did not receive blood products (US $550.20).</p>

<p><strong>CONCLUSION: </strong>The comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care.</p>
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