Burden of hospitalisation among older people in the Brazilian public health system: a big data analysis from 2009 to 2015

2019 ◽  
Vol 73 (6) ◽  
pp. 537-543 ◽  
Author(s):  
Roger Daglius Dias ◽  
Jacson Venancio de Barros
Keyword(s):  
Public Health ◽  
Hospital Mortality ◽  
Older People ◽  
Health System ◽  
Hospital Admissions ◽  
Public Health System ◽  
Average Length ◽  
Admission Rate ◽  
Older Population ◽  
Icu Admission

BackgroundThe world’s population is progressively ageing, and this trend imposes several challenges to society and governments. The aim of this study was to investigate the burden generated by the hospitalisation of older (>60 years) compared with non-older population, as well as the epidemiology of these hospital admissions.MethodsUsing the Brazilian Unified Health System (known as ‘Sistema Único de Saúde’ (SUS)), an analysis of all hospital admissions of adult patients in the SUS from 2009 to 2015 was undertaken. The following indicators were used: hospital admission rate, intensive care unit (ICU) admission rate, average length of hospital and ICU stay, hospital mortality and average reimbursement per hospitalisation.ResultsA total of 61 958 959 admissions during the 7-year period, were analysed, encompassing 17 893 392 (28.9%) older patients. Elderly represent 15% (n=21 294 950) of the Brazilian adult population, but are responsible for 29% (n=17 893 392) of hospitalisations, 52% (n=1 731 299) of ICU admissions and 66% (n=1 885 291) of hospital mortality. Among the adults, elderly represents 39% of the total reimbursement made related to admission/hospitalisation. For 2009 to 2015, while the older population increased 27%, ICU admission rate increased 20%; the average length of ICU stay was 12% higher in 2015 (6.5 days) compared with 2009 (5.8 days); and the hospital mortality increased from 9.8% to 11.2%.ConclusionThese findings illustrate the current panorama of the burden due to hospitalisation of older people in the Brazilian public health system, and evidence the consolidation of the epidemiological transition toward the predominance of non-communicable diseases as the main cause of hospitalisation among the elderly in Brazil.

scholarly journals VALVE SURGERY: RESULTS OF THE BRAZILIAN PUBLIC HEALTH SYSTEM

2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Kleber Do Espirito Santo Freire ◽  
Melissa Alves de Carvalho ◽  
Taiane Araújo Brito ◽  
Marta Silva Menezes
Keyword(s):  
Public Health ◽  
Heart Disease ◽  
Health System ◽  
Heart Valve ◽  
Hospital Admissions ◽  
Public Health System ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Southeast Region ◽  
The North

Purpose: Description of hospitalization, mortality rates and cost of heart valve surgery performed by Brazilian Public Health System from 2008 to 2013. Methods: A cross-sectional, observational descriptive study about the procedures of valve surgeries performed in Brazil, from January 2008 to December 2013, by region and federative unit. The study was conducted using the electronic database of Health System Information (Datasus). Results: In the period of study, the total authorizations for hospital admissions for heart valve surgery in Brazil was 65,138 with an average of 10,586 per year. The Southeast region had the highest number of admission and the North the least. The Southeast region concentrated about 45% of valve surgeries in the last six years, while the North was responsible for only 3.80%. The number of heart valve surgeries in Brazil was 5.8/100,000 inhabitants. The national mortality rate during this procedure was 8.8%. The average cost in dollars applied for each valve surgery in 2012 was U$5,947 per 100,000 inhabitants and about $65,757,845 were spent in hospitalization in 2013. Conclusions: The study showed that Brazil spends a high investment in the surgical treatment of valvular heart disease. It is necessary to reinforce the institution of public health programs aimed to rheumatic heart disease in our country to change that reality.

scholarly journals Incidência de internações por eventos adversos a medicamentos em Minas Gerais

2017 ◽  
Vol 27 (1) ◽  
pp. 24936
Author(s):  
Yasmin De Oliveira Machado Silva ◽  
Marina Guimarães Lima
Keyword(s):  
Public Health ◽  
Length Of Stay ◽  
Health System ◽  
Hospital Stay ◽  
Adverse Drug Events ◽  
Hospital Admissions ◽  
Public Health System ◽  
Psychiatric Service ◽  
Medical Specialty ◽  
Minas Gerais

Aims: To estimate the rate of hospital admissions due to adverse drug events under the Unified Public Health System in the State of Minas Gerais, Brazil, according to demographic variables, length of stay, medical specialty, and cause of hospitalization.Methods: Cross-sectional study with secondary data on hospital admissions paid for under the Unified Health System in Minas Gerais between 2012 and 2014. The incidence of hospitalizations for adverse drug events was calculated and expressed per 1,000 admissions. The total number of admissions and of hospitalizations for adverse drug events was described according to the patient’s gender and age, length of hospital stay, and the medical specialty. The frequencies of the different categories of the variables of interest were compared using the chi-square test and a 5% significance level.Results: The incidence of hospitalizations for adverse drug events was 25.9 per 1,000 admissions paid for by the Unified Public Health System. Men had a higher rate of hospitalizations for adverse drug events than women (2.7% vs. 2.4%). In terms of age, the highest rate of hospitalizations for adverse drug events was observed among individuals aged 60 years or older (3.4%) and the lowest rate was among children aged up to 9 years (0.6%). A higher rate of hospitalizations for adverse drug events was observed when the length of stay was 15 days or longer (7.6%) and in patients admitted from the psychiatric service (8.3%).Conclusions: Adverse drug events were an important cause of hospitalization under the Unified Public Health System in Minas Gerais between 2012 and 2014. Hospitalization for adverse drug events was associated with being male, being 60 years or older, having a longer hospital stay, and being admitted from the psychiatric service. Actions that promote pharmacovigilance in health institutions are necessary for the prevention of adverse drug events.

Abstract 19700: Recent Trends in Procedure Type, Morbidity and In-hospital Outcomes of Patients With Peripheral Artery Disease: Data From the Brazilian Public Health System

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bruno R Nascimento ◽  
Luisa C Brant ◽  
Maria Letícia L Lana ◽  
Eduardo L Lopes ◽  
Antônio Luiz P Ribeiro
Keyword(s):  
Public Health ◽  
Hospital Mortality ◽  
Health System ◽  
Peripheral Artery Disease ◽  
Public Health System ◽  
Treatment Modalities ◽  
Peripheral Artery ◽  
Hospital Outcomes ◽  
Recent Trends ◽  
Artery Disease

Introduction: The prevalence of peripheral artery disease (PAD) is rising worldwide, with a considerable impact on health care systems. We aimed to characterize the recent trends in surgical, percutaneous and clinical therapeutic procedures and in-hospital outcomes of PAD among all hospitalized patients in the Brazilian Public Health System between 2008 and 2012. Methods: Nationwide data of all hospitalizations in the Brazilian Public Health System (DataSUS) database in 2008, 2010, and 2012 were analyzed regarding the frequency of hospitalizations due to PAD (endovascular - EVR, surgical revascularizations - SR and clinical treatment - CT), length of hospital stay and in-hospital mortality and associated costs to the health system. Results: The number of hospitalizations related to PAD (EVR, SR and CT) remained stable from 2008 to 2012: 28,091 and 28,151 respectively, accounting for 0.25% and 0.24% of all in-hospital procedures. However, there was a significant change in the proportions of treatment modalities used in this period. In 2008: SR = 8,001 (29%), EVR = 3,207 (11%) and CT = 16,887 (60%); in 2010: SR = 7,999 (30%), EVR = 4,020 (15%) and CT: 14,849 (55%); and in 2012: SR = 7,882 (28%), EVR = 5,044 (18%) and CT = 15,225 (54%); p<0.001. The results show a 57% increase in EVR, and a 9.8% decrease in CT in this period. Total costs raised 23%, from US$ 18.6 million in 2008 to R$ 22.9 million in 2012 (p< 0.001), with a marked 92% increase in EVR costs (R$ 5.3 to 10.0 million), compared to SR (11%) and CT (30%). Global mean hospital days did not change from 2008 to 2012 (5.8 to 5.7 days), whereas it decreased for EVR (5.7 to 4.8, p<0,001). Hospital mortality decreased from 2008 to 2012 for EVR (2.0 to 1.4%, p=0.048), increased for CT (5.1 to 5.8%, p=0.002) and remained stable for SR (8.5 to 8.8%, p=0.44). Overall mortality, however, increased from 6.2% in 2008 to 6.7% in 2012 (p=0.004). Conclusion: There is an increasing proportion of EVR for PAD in Brazil, with a concomitant increase in costs, mainly related to these procedures. Our administrative data-based analysis depicts the significant rise of overall PAD mortality in Brazil, especially in clinically treated patients, emphasizing the need of controlling PAD risk factors and promoting its early diagnosis and effective management.

scholarly journals Costs for in hospital treatment of urinary lithiasis in the Brazilian public health system

2011 ◽  
Vol 9 (4) ◽  
pp. 518-522 ◽  
Author(s):  
Fernando Korkes ◽  
Jarques Lúcio da Silva II ◽  
Ita Pfeferman Heilberg
Keyword(s):  
Public Health ◽  
Hospital Admission ◽  
Health System ◽  
Hospital Admissions ◽  
Public Health System ◽  
Epidemiological Data ◽  
Hospital Treatment ◽  
The Public ◽  
Urinary Lithiasis ◽  
Mean Cost

ABSTRACT Objective: To estimate costs associated to hospital treatment of urinary lithiasis in the Brazilian public health system as well as to evaluate demographic and epidemiological data referred to hospital admissions in the Brazilian public health system (or unified health care system). Methods: Data from the Informatic Department of Brazilian public health system were obtained as referred to costs in hospital admissions for urinary lithiasis during 2010 and also epidemiological data from 1996 through 2010. Results: There were 69,039 hospital admissions for urinary lithiasis, totaling 0.61% of all hospital admissions in the Brazilian public health system. The mean cost of each of these hospital admissions was US$ 240,23 or R$ 423.42 having as result an overall cost of US$ 16,240,378.00 or R$ 29.232.682,56. Hospital admissions for urinary lithiasis in the Brazilian public health system increased 69% from 1996 to 2010 (43,176 versus 69,309; p < 0.001; OR = 1.69). The number of hospital admissions was 5% greater between December and March as compared to the period between June and September (35,290 versus 33,749; p < 0.001; OR = 1.10). For Caucasian patients the hospital admission was 75% greater as compared to black patients (63.2% versus 35.8%; p = 0.02; OR = 1,75). Conclusion: Hospital admission for urinary liyhiasis has an elevated impact on the public health system with a cost of US$ 16,2 or R$ 29.2 million per year. The number of hospital admissions was greater in hotter months than in cold ones and also in the last decade, mainly in Caucasian population. These data may be helpful for the organization and optimization of health programs in the public health system as referred to prevention and treatment of urinary lithiasis in Brazil.

scholarly journals Prevalence and Economic Impact of Acute Myocardial Infarction in the Brazilian Public Health System: Care and Economic Analysis and the Impacts of the Coronavirus Disease

2021 ◽  
Author(s):  
June Alisson Westarb Cruz ◽  
Gustavo Martini Buso ◽  
Lidia Ana Zytynski Moura ◽  
Maria Alexandra Viegas Cortez da Cunha ◽  
Tiago Zequinão ◽  
...  
Keyword(s):  
Public Health ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health System ◽  
Public Health System ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Economic Behavior ◽  
Hospitalization Costs ◽  
Using Data

Abstract Background This study aimed to describe the general and specific context of hospitalizations for acute myocardial infarction (IAM) in the Brazilian public health system and its main indicators of economic care in the pre- and post-coronavirus-disease (COVID-19) period. Methods The main assistance and economic indicators of care related to IAM, together with the Brazilian public health system, were evaluated in the period between January 2011 and April 2021, comparing the pre- and post-pandemic indicators. The research figures were descriptive and exploratory, using data from the Ministry of Health. The main data evaluated were lethality, number of hospitalizations, average length of hospital stay, and hospitalization costs. The ARIMA and general regression models were used to analyze the monthly outcomes pre and post COVID-19, thus enabling the alteration of care and economic behavior of IAM cases with the public health system. Results Hospitalization for IAM has been on the rise for the past 10 years, with a slight decrease after COVID-19. There was an equally slight increase in lethality, with a significant decrease in the mean length of stay of hospitalized patients. The economic aspects of IAM show that more than US$ 762 million were invested during the reporting period. The average ticket presents a clear decrease in investment per capita, with a real devaluation of 70.04% in the period from 2011 to April 2021, which may be related to two main hypotheses: (1) increased effectiveness and (2) cost analysis of the effectiveness of care and/or chronic underfunding of the Brazilian public health system. Conclusions There was a historical increase in hospitalizations and a reduction in IAM-related deaths.

scholarly journals Prevalence and costs of headaches for the public health system in a town in the interior of the state of São Paulo

2001 ◽  
Vol 59 (3A) ◽  
pp. 504-511 ◽  
Author(s):  
Marcelo E. Bigal ◽  
Janaína O.M. Bigal ◽  
Carlos A. Bordini ◽  
José G. Speciali
Keyword(s):  
Public Health ◽  
Health System ◽  
Hospital Admissions ◽  
Public Health System ◽  
Well Being ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
The Public

Despite the high prevalence, impact and economic importance of headaches, studies on this subject are rare in Brazil. The aim of the present study was to estimate the prevalence of headaches in the public health system of a town in the interior of the State of São Paulo, as well as to estimate the costs resulting from its management. Data refer to the year of 1998 and were obtained according to the following steps: 1) territorial and demographic characterization of the municipality; 2) characterization of the financial indices and social well-being; 3) budget characteristics of the municipality; 4) evaluation of the structuring of the medical service; 5) determination of the prevalence of headaches at different patient care levels; and 6) calculation of the costs of headaches. Headaches represented 7.9% of all visits at basic health units, 9.7% in the emergency room and 1.1% of hospital admissions. The total costs were R$ 85,131.31 (US$ 70,942.76) corresponding to R$ 7.59 (US$ 6,32) per inhabitant/year. The present study shows the need for epidemiological and economic impact studies, which would provide the basis for the rational use of health funds.

scholarly journals Impact of first year renal replacement therapy on the hospital admissions of a regional public health system

2019 ◽  
Vol 39 (6) ◽  
pp. 653-663
Author(s):  
Paula Lopez-Sanchez ◽  
Jose Portolés ◽  
Leyre Martín Rodríguez ◽  
Fernando Tornero ◽  
Arturo Jose Ramos Martin-Vegue ◽  
...  
Keyword(s):  
Public Health ◽  
Renal Replacement Therapy ◽  
Health System ◽  
Replacement Therapy ◽  
Hospital Admissions ◽  
Public Health System ◽  
First Year ◽  
Regional Public Health

scholarly journals AB0833 HOSPITAL ADMISSIONS FOR RHEUMATOID ARTHRITIS AND OTHER INFLAMMATORY POLYARTHROPATHIES IN THE BRAZILIAN PUBLIC HEALTH SYSTEM

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1440.3-1441
Author(s):  
A. Dal Pra Wendt ◽  
F. Milene Cardozo
Keyword(s):  
Public Health ◽  
Rheumatoid Arthritis ◽  
Health System ◽  
Rio De Janeiro ◽  
Hospital Admissions ◽  
Public Health System ◽  
National Level ◽  
Mato Grosso ◽  
Unified Health System ◽  
Southeastern Region

Background:Rheumatoid arthritis is an idiopathic autoimmune disease that is characterized by symmetrical peripheral polyarthritis. The disease leads to the destruction of joints due to erosion of both bone and cartilage. The other inflammatory polyarthropathies are a group composed of 61 diseases, according to the International Classification of Diseases (ICD-10). Drug treatment is carried out through outpatient follow-up, with no need for hospitalization in mild and / or controlled cases. When surgical treatment is recommended or there are complications from rheumatoid arthritis or other inflammatory polyarthropathies, hospitalization is indicated. In addition, Brazil has a broad public health system, called the Unified Health System (UHS), responsible for most health procedures carried out at the national level, especially with regard to the socioeconomically vulnerable population.Objectives:To investigate the number of hospital admissions for rheumatoid arthritis and other inflammatory polyarthropathies in UHS during the past three years.Methods:This is a quantitative and retrospective survey based on the data available on the website of the Department of Informatics of the Brazilian Unified Health System. The data are freely accessible and public domain. Information was collected about the period between December 2017 and November 2020, referring to the number of hospitalizations for rheumatoid arthritis and other inflammatory polyarthropathies in all five regions that make up Brazil.Results:The number of hospitalizations for rheumatoid arthritis and other inflammatory polyarthropathies fluctuated, between December 2017 and November 2020, from 1083 to 1311 per month, with an average of 1184 and a total of 38228 hospitalizations over the three years analyzed. Throughout the national territory, the region with the least monthly admissions was the central-west (which comprises the states of Mato Grosso, Mato Grosso do Sul, Distrito Federal and Goiás), with 2562 total admissions and an average of 71.1 monthly admissions. In contrast, the region with the highest number of cases was the southeastern region (where the states of Espírito Santo, Minas Gerais, São Paulo and Rio de Janeiro are located), with a total of 13173 hospitalizations and a monthly average of 365.9, representing 34,4% of hospitalizations in the country. Such data is in line with the Brazilian demography, since the central-west region is the second least inhabited (with 16.09 million inhabitants) and the southeastern region is the most densely inhabited (with 80.35 million inhabitants). The number of monthly hospitalizations, which remained above 1000 from the first month analyzed (December 2017) until February 2020, dropped to 990 in March of the same year and 651 in April, maintaining an average of 678.2 in next seven months.Conclusion:It is concluded that the number of hospitalizations for rheumatoid arthritis and other inflammatory polyarthropathies in Brazil dropped significantly between March and April 2020, a period that coincides with the beginning of the COVID-19 pandemic in the country, possibly as a result both of the changes in the Brazilian medical care model (in relation to the requirements for hospitalization) and as a result of the lower demand by individuals for hospitals due to fear of contamination by the new coronavirus.References:[1]BATES, B. Propedêutica Médica. 12ª ed. Rio de Janeiro: Guanabara Koogan, 2018.Disclosure of Interests:None declared

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