Evaluation of the Impact of the Implementation of GES Public Policies on the Mortality of Surgeries in Children with Heart Malformations Between 2001 and 2017.

Abstract

Introduction: Prior to GES program initiation in 2002, congenital heart disease (CC) mortality accounted for 33% of deaths from congenital anomalies in children under 1 year of age. The GES seeks to increase the number of CC surgical treatments by streamlining the screening process and prenatal diagnosis of CC.

Objective: Assess how the GES has impacted lethality and mortality in CC surgeries, based on age, gender, days of stay, and forecast.

Methods: A case study and retrospective observational controls were conducted on 43024 hospital outflows of time series prais-weinstein analysis. Contingency tables were prepared with data on hospital egress, age, gender and forecast for 2001 and 2017. The Fisher Test was used p<0.05.

Results: In 2001, the average age was 8.7 years (IC-8.1-9.3), with no difference in mortality by sex (3.97% v/s 4.08%; P> -0,889). Odd's ratios associated with sex (0.971 higher than men v/s women) IC-0, 820-1.191; p-0.861>0.05; Age OR'S (0.981 per year ) IC-0.971-0.991; p<0.0001 OR'S Forecast (FONASA-5.814 IC 1.642- 20.589 that the private ISAPRE, DIPRECA, CAPREDENA System; confirmed our research hypothesis Mortality was lower in the group undergoing surgery (OR 1,279; IC-0,8596-1,922), with a death RR of 1.01 (IC-0.9937-1,025).

Higher mortality occurs in the public sector (2.66% v/s 1.36%; p<0.001), which increased for 2016 (3.11% v/s 0.81% p-0.1273).

Discussion: This study observed a statistically significant difference in CC mortality as expected for 2001 (pre-GES), which ceased to be the case in 2016. GES reduced CC mortality from 33% to 4.02% in deaths from congenital anomalies.