CARTAS CIENTÍFICAS

 

Evidence of improvement of the prescription standard and cost reduction with the use of special nutritional formulae in Rio Grande do Sul state/Brazil after implementation of a reference center

Evidencias de la mejora en el patrón de prescripción y reducción de costos con la utilización de fórmulas nutricionales especiales en el estado de Rio Grande do Sul/Brasil mediante la implementación de un servicio de información

 

 

Correspondence

 

 

Different clinical conditions demand the use of Special Nutritional Formulae (SNF) as enteral or parenteral nutritional therapy, being used exclusively or associated with other forms of nutrition^1,2. Food allergies³, metabolic disorders⁴ or short bowel syndrome⁵ are instances in which SNF is fundamental in the treatment and indispensable for the good clinical evolution of the patients.

This study intended to compare the first (period 1) and the third (period 2) year of implementation of the Reference Center (RC) in SNF in a state in the south of Brazil, regarding the granting of the requests of users of Brazilian Health Care System (SUS), characteristics of the proceedings and solicitants and costs involved in the purchase of SNF. The research unit for the study was each request received by the RC for analysis and judgment, and is characterized by a historic evaluation of the data.

All the 1077 requests received in period 1 and the 944 in period 2 were evaluated. There was improvement of the information in the requests (p < 0.001) and the percentage of requests for SNF approved (p < 0.001), reaching more users (p = 0.004). The requests of the undernourished (p = 0.002) and the elderly increased (p < 0.001) and the repetition of requests in the period decreased (p < 0.001). The estimated cost per user decreased from US$ 8,742 to US$ 6,297.

The final result found suggesting a better management of SNF, followed by the apparent expansion of the access of SUS users to formulae. It is believed that clinical indications based on technical opinions by the RC, and the consequent rational use of SNF, have led to economy of public money in the period evaluated.

 

J. da Silva Fink¹, E. D. de Mello^1,2 and P. Dornelles Picon^1,2,3
1Graduate Program in Medicine. Medical Science. Medical School of Universidade Federal do Rio Grande do Sul/Brazil.
²Hospital de Clínicas de Porto Alegre. Rio Grande do Sul/Brazil.
³Coordination of the Pharmaceutical Care Policy of the State Health Department of the state of Rio Grande do Sul/Brazil.

 

References

1. Cuerda C, Chicharro ML, Frias L, Garcia Luna PP, Cardona D, Camarero E et al. [Registry of home-based enteral nutrition in Spain for the year 2006 (NADYA-SENPE Group)]. Nutr Hosp 2008; 23 (2): 95-99.        [ Links ]

2. Peter JV, Moran JL, Phillips-Hughes J. A metaanalysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients. Crit Care Med 2005; 33 (1): 213-220.        [ Links ]

3. Agostoni C, Axelsson I, Goulet O, Koletzko B, Michaelsen KF, Puntis J et al. Soy protein infant formulae and follow-on formulae: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2006; 42 (4): 352-361.        [ Links ]

4. Leonard JV, Morris AA. Inborn errors of metabolism around time of birth. Lancet 2000; 356 (9229): 583-587.        [ Links ]

5. Razack R, Seidner DL. Nutrition in inflammatory bowel disease. Curr Opin Gastroenterol 2007; 23 (4): 400-405.        [ Links ]

 

 

Correspondence:
Jaqueline da Silva Fink.
Rua Leopoldo de Freita, 83, apto. n.^o 304.
91030-460 Porto Alegre, RS.
E-mail: jaquelinefink@yahoo.com.br

Recibido: 14-VII-2009.
Aceptado: 27-VII-2009.