Context

Optimization of resource use becomes even more crucial in developing countries due to the scarcity of health care system financing sources. The Brazilian public health care system, Sistema Único de Saúde, SUS, is under construction since a health care reform a decade ago. Intense efforts are currently being made to further develop states ’ health care networks, family care teams, professionals ` formation including specialists, aiming to improve access, equity and social justice. Yearly, in Brazil, congenital heart defects are associated with near 100.000 hospitalizations out of 12 millions hospital admissions (0.10%). Detection and diagnosis of these conditions have increased 12 % since the year 2000. Related long lengths of stays have motivated explanatory and management research, in a hope to find means for optimization of the use of scarce resources. The Heart Institute/Clínicas Hospital of the São Paulo University Medical School, InCor/HC-FMUSP, is the major reference centre for congenital heart surgeries in Brazil and does receive, yearly, near 1,000 cases with congenital heart malformations. Most complex cases are referred to the InCor and congenital heart surgeries account for more than 10 % of all surgical interventions done at the InCor. Public and private payers are, thus, expecting transparent and rigorous account of the results for each investment. In the context of significant amounts of investment for the congenital heart surgery programs, risk stratification1 becomes an important instrument to demonstrate the complexity of these programs. Evaluation of the quality and the quantities of required resources may allow better planning for the InCor and for the payers, particularly for the government. In order to facilitate evaluations, the Heart Institute has developped an electronic medical record in an integrated information system. Objective This partial report aims to show the first results and to discuss the cost-effectiveness methods applied