[Financial and health impact of two models of providing prostheses in a public health systemImpacto econômico e sanitário de dois modelos de fornecimento de próteses em um sistema público de saúde].

Objective: Compare the health outcomes and financial outcomes of two systems for the procurement of prostheses: the traditional system, in which procurement is initiated when a product is requested; and the "Prosthesis Bank" model, based on a current inventory of supplies. Methods: Descriptive-analytical study of users of Ministry of Health services in the province of Buenos Aires, Argentina. The patients belonged to two study groups: 1) prostheses were provided through the traditional computerized system for hospital procurement and contracting, known as SIPACH; and 2) prostheses were provided by the Prosthesis Bank. The study was limited to endovascular prostheses (coronary stents) and hip prostheses. Official government databases were used. The study period was from 01/01/2018 to 31/10/2022. The variables analyzed were: age, sex, diagnosis, hospital, type of implant or prosthesis, date of request, date received, unit price, direct and indirect costs, average cost of daily hospitalization, cost-effectiveness, and budgetary impact. Results: A total of 4 106 applications were analyzed. In the traditional system: 13.5% of patients did not get their prostheses; it took 50 days longer than with the Prosthesis Bank; and total costs were higher in SIPACH (coronary stent, +463%; hip prosthesis, +133%). The Prosthesis Bank saved USD 3.2 million annually and prevented 22 deaths through early provision of endovascular prostheses. Conclusions: The Prosthesis Bank proved to be superior to the traditional model for providing prostheses, both in terms of health-by achieving better access, shortening waiting times, and avoiding deaths-and financially-by significantly reducing unit and overall prices, achieving significant savings in allocated budgets.