Healthcare telemonitoring and business dynamics: challenges and opportunities for SUS

ABSTRACT OBJECTIVE To point out challenges and opportunities for the Brazilian Unified Health System (SUS) with the use of telemonitoring to face the increasing costs of non-communicable chronic diseases, based on its general panorama in Brazil, business dynamics and reapplication of data from American studies. METHODS Quali-quantitative approach with exploratory research. The field work focused on the analysis of the national market from private companies, since no experiences or studies related to this theme were identified in the SUS. To analyze the panorama and market dynamics, we investigated the offer of this technology based on the products and services available and their demand by reference hospitals the ten largest private health plan companies. To support the central discussion, we analyzed the reduction of costs with hospital admissions by the SUS due to chronic non-communicable diseases sensitive to telemonitoring (HCDST), using data from Datasus and some American studies from the MEDLINE/PubMed database. RESULTS Although in the embryonic phase, business agents search for new business opportunities, whereas public initiatives for the use of telemonitoring in collective health seem inexistent. The reapplication of U.S. data would reduce spending on HCDST and provide benefits, such as the reduction in emergency room care, acute hospitalizations, readmissions and home care time, among others, which point to even greater economic gains. CONCLUSIONS The development of a major project to reduce HCDST using this technology has the potential to advance in a comprehensive network of primary care, contribute to a greater dynamism of the national productive and innovative base and induce innovations along the chain of this emerging industry.摘要 研究目的：本研究基于巴西国内整体发展图景、产业运行动态以及美国相关研究的数据复用，旨在探讨远程监护（telemonitoring）技术应用于巴西统一健康系统（SUS）所面临的挑战与机遇，以应对慢性非传染性疾病诊疗成本持续攀升的问题。 研究方法：本研究采用定性与定量相结合的探索性研究方法。鉴于目前SUS体系内尚未发现与该主题相关的实践经验或研究成果，实地调研聚焦于私营企业主导的国内市场分析。为全面剖析行业现状与市场动态，本研究结合现有产品与服务供给情况，以及巴西十大私营健康保险公司旗下重点医院的需求情况，对该技术的市场供给展开调研。为支撑核心讨论，本研究借助巴西国家卫生数据系统（Datasus）以及MEDLINE/PubMed数据库中的美国相关研究数据，分析了远程监护敏感型慢性非传染性疾病相关住院（HCDST）带来的SUS住院成本削减情况。 研究结果：尽管当前该领域仍处于萌芽阶段，商业主体仍在积极探寻新的商业机遇，而SUS体系内面向群体健康开展远程监护的公共举措近乎空白。复用美国相关研究数据可有效降低SUS在HCDST上的支出，并带来多重收益，例如减少急诊就诊、急性住院、再入院以及居家护理时长等，由此可实现更为可观的经济增益。 研究结论：开发基于该技术的大型HCDST控费项目，有望推动构建全面的初级保健网络，助力国内生产与创新基础更具活力，并推动这一新兴产业全链条的技术创新。