Trends in Hospital Admission Rates and Associated Direct Healthcare Costs in Brazil: A Nationwide Retrospective Study between 2000 and 2015

• Published in: Innovation (New York, NY) Vol. 1; no. 1; p. 100013
• Main Authors: Zhao, Qi, Coelho, Micheline S.Z.S., Li, Shanshan, Saldiva, Paulo H.N., Abramson, Michael J., Huxley, Rachel R., Guo, Yuming
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 21.05.2020; Elsevier
• Subjects: birth; Brazil; cancer; circulatory disease; diabetes; disease burden; hospital admission; injury; hospital admission; circulatory disease; Brazil; birth; cancer; disease burden; injury; diabetes
• ISSN: 2666-6758; 2666-6758
• DOI: 10.1016/j.xinn.2020.04.013

In Brazil, the increase in non-fatal events presents a new, unprecedented challenge for the free and universally accessible public healthcare system (SUS), the size and nature of which has yet to be reliably quantified. We examined the change in all-cause and cause-specific SUS hospital admissions during 2000 to 2015. Data on hospital admissions across 1,816 cities were collected from the Brazilian Unified Health System. The age-standardized rates of hospital admissions, the associated healthcare costs, and length of hospital stay were quantified. Stratum analyses were performed by age, sex, region, and cause-specific categories. Hospital admission rates decreased by 10.2‰ per decade to 54.2‰ in 2015. For admissions in 2015, healthcare costs per patient equaled US$353 (an increase of $23.5/year since 2000) with an average length of hospital stay of 5 days (a decline of 0.04 days/year since 2000). Circulatory diseases incurred the greatest financial costs. Children and the elderly were most susceptible, especially for pneumonia. Injury and poisoning were the primary reason for admission in adult males, whereas maternal and other female-specific conditions were the highest burden in females. The burden of hospital admission was highest in the south and lowest in the north and northeast. Although hospital admission rates and length of stay have decreased in Brazil since 2000, the decline has been offset by an increase in direct healthcare costs. Age-, sex-, and region-specific features of the disease burden should be factored into future plans for healthcare expenditure in Brazil. [Display omitted] •Hospital admission rate and length of hospital stay have declined since 2000•Healthcare costs of hospital admissions have increased since 2000•Infants and the elderly had the highest admission rate, especially due to pneumonia•Injury and maternal conditions were the primary causes in adult males and females•Greatest healthcare burden occurred in the south of Brazil