The cost-effectiveness of the treatment of acute ischemic stroke with the use of thrombolytics in Brazil

Introduction: Ischemic stroke causes major impacts on morbidity and mortality and intravenous thrombolysis is one of the main treatments. However, it has important temporal limitations, which justifies the study of other techniques. Objectives: Analyze the cost-effectiveness of treatments for acute stroke with the use of thrombolytics. Methodology: Epidemiological study with data from the Sistema de Informações Hospitalares do Ministério da Saúde, between 2015 and 2020 in Brazil. Results: There were 16488 hospitalizations, with an average cost of R$ 2687.70 (±379.40) and an average stay of 8.80 (±0.99) days. From 2015 to 2017, these values were, on average, 1829.67 (±917.46) hospitalizations, R$ 2715.50 (±190.86) and 9.80 (±1.62) days. Between 2018 and 2020, there are 3666.33 (±437.58), R$ 2773.22 (±108.86) and 8.13 (±0.29) days. The Northeast, Southeast and South of the country predominated with 36.09% (±0.73), 27.15% (±0.68) and 32.02% (±0.71) of occurrences, respectively. Average investments per hospitalization, for these regions, were R$ 2397.89 (±82.45), R$ 3178.29 (±38.89) and R$ 2806.16 (±56.33). As for the average stay, it was 7.30 (±1.11), 9.11 (±0.89) and 9.40 (±0.78) days. In public systems, 65.09% (±2.97) of registered treatments, the average cost was R$ 2815.09 (±122.34) and the average stay was 12.00 (±1.33) days. In private institutions these values were R$ 2747.14 (±98.13), and 8.90 (±0.92) days. Conclusions: There were increases in hospitalizations and costs with a reduction in length of stay. In addition, there were pronounced disparities between the regions of the country and public and private systems, which undermine equity in the health system.