Abstract:INTRODUÇÃOO grande impacto da morbimortalidade cardiovascular na população brasileira, que tem o diabetes mellitus (DM) e a hipertensão arterial (HA) como importantes fatores de risco, trazem um desafio para o sistema público de saúde: a garantia de acompanhamento sistemático dos indivíduos identificados como portadores desses agravos, assim como o desenvolvimento de ações referentes à promoção da saúde e à prevenção de doenças crônicas não transmissíveis.
O Plano de Reorganização da Atenção à HipertensãoArter… Show more
“…In the early 2000s, Brazil initiated a series of strategies aiming at increasing access of the population with diabetes and hypertension to healthcare services [ 15 ] and providing early diagnosis for diabetes through a national population-based screening program [ 16 , 17 ]. Later, a National Strategic Plan for chronic NCD was developed and implemented [ 18 ].…”
Diabetes is associated with a significant burden globally. The costs of diabetes-related hospitalizations are unknown in most developing countries. The aim of this study was to estimate the total number and economic burden of hospitalizations attributable to diabetes mellitus (DM) and its complications in adults from the perspective of the Brazilian Public Health System in 2014. Data sources included the National Health Survey (NHS) and National database of Hospitalizations (SIH). We considered diabetes, its microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular complications (coronary heart disease, cerebrovascular disease, and peripheral arterial disease), respiratory and urinary tract infections, as well as selected cancers. Assuming that DM patients are hospitalized for these conditions more frequently that non-DM individuals, we estimated the etiological fraction of each condition related to DM, using the attributable risk methodology. We present number, average cost per case, and overall costs of hospitalizations attributable to DM in Brazil in 2014, stratified by condition, state of the country, gender and age group. In 2014, a total of 313,273 hospitalizations due to diabetes in adults were reported in Brazil (4.6% of total adult hospitalization), totaling (international dollar) Int$264.9 million. The average cost of an adult hospitalization due to diabetes was Int$845, 19% higher than hospitalization without DM. Hospitalizations due to cardiovascular diseases related to diabetes accounted for the higher proportion of costs (47.9%), followed by microvascular complications (25.4%) and DM per se (18.1%). Understanding the costs of diabetes and its major complications is crucial to raise awareness and to support the decision-making process on policy implementation, also allowing the assessment of prevention and control strategies.
“…In the early 2000s, Brazil initiated a series of strategies aiming at increasing access of the population with diabetes and hypertension to healthcare services [ 15 ] and providing early diagnosis for diabetes through a national population-based screening program [ 16 , 17 ]. Later, a National Strategic Plan for chronic NCD was developed and implemented [ 18 ].…”
Diabetes is associated with a significant burden globally. The costs of diabetes-related hospitalizations are unknown in most developing countries. The aim of this study was to estimate the total number and economic burden of hospitalizations attributable to diabetes mellitus (DM) and its complications in adults from the perspective of the Brazilian Public Health System in 2014. Data sources included the National Health Survey (NHS) and National database of Hospitalizations (SIH). We considered diabetes, its microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular complications (coronary heart disease, cerebrovascular disease, and peripheral arterial disease), respiratory and urinary tract infections, as well as selected cancers. Assuming that DM patients are hospitalized for these conditions more frequently that non-DM individuals, we estimated the etiological fraction of each condition related to DM, using the attributable risk methodology. We present number, average cost per case, and overall costs of hospitalizations attributable to DM in Brazil in 2014, stratified by condition, state of the country, gender and age group. In 2014, a total of 313,273 hospitalizations due to diabetes in adults were reported in Brazil (4.6% of total adult hospitalization), totaling (international dollar) Int$264.9 million. The average cost of an adult hospitalization due to diabetes was Int$845, 19% higher than hospitalization without DM. Hospitalizations due to cardiovascular diseases related to diabetes accounted for the higher proportion of costs (47.9%), followed by microvascular complications (25.4%) and DM per se (18.1%). Understanding the costs of diabetes and its major complications is crucial to raise awareness and to support the decision-making process on policy implementation, also allowing the assessment of prevention and control strategies.
“…It should be noted that, despite the aging of the population and the nutritional transition, with increased overweight and other factors associated with DM, several public policies to deal with the diseased were implemented in the period analyzed (11) . The Plan to Reorganize Health Care for Arterial Hypertension and Diabetes Mellitus (HiperDia) was conceived to identify cases, train personnel, and diagnose and distribute medication (17) . Furthermore, the period saw an increase in medication provided by the Popular Pharmacy (18) , easier access to Family Health Strategy services (19) , restrictions to smoking (20) , and encouragement of healthy lifestyle habits due to the plan of strategic actions against non-transmissible chronic diseases (21) , all of which are public policies that may have contributed to reduce hospitalizations.…”
Objective: To analyze the trends of hospital admissions and deaths from diabetes mellitus in the 18 host municipalities of the 19 regional health coordination offices and in Rio Grande do Sul, 2000-2020. Method: Ecological study with secondary data collected in the Hospital Information System, the Mortality Information System, and the Brazilian Institute of Geography and Statistics, from 2000-2020. Coefficients were standardized using the direct method and Prais-Winsten regression analysis. Results: A downward trend wasfound in the coefficients of hospitalizations for diabetes mellitus in most cities and states. In 2020, for both areas, hospitalizations for diabetes mellitus were below the average of the period. The mortality trend remained stationary in almost all municipalities and in the state. Conclusion: There was evidence of a decrease in hospitalizations and stationary mortality by DM in most municipalities analyzed, possibly due to the policies and actions implemented in the period, despite the aging of the population.
“…Deve-se ressaltar que apesar do envelhecimento da população e da transição nutricional, com aumento do excesso de peso, fatores associados à ocorrência de DM, diversas políticas públicas de combate à doença ocorreram no período analisado (11) . O Plano de Reorganização da Atenção à Hipertensão Arterial e ao Diabetes Mellitus (HiperDia) foi concebido para identificação de casos, treinamento de pessoal, diagnóstico e distribuição de medicamentos (17) . Além disso, no período assistiu-se à ampliação dos medicamentos ofertados pela Farmácia Popular (18) , pelo acesso facilitado aos serviços de saúde pela Estratégia Saúde da Família (19) , pelas restrições ao tabagismo (20) e pelo estímulo à hábitos saudáveis de vida mediante o Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis (21) , ou seja, políticas que podem ter contribuído para a diminuição das internações.…”
RESUMO Objetivo: Analisar a tendência das internações hospitalares e dos óbitos por diabetes mellitusnos 18 municípios-sede das 19 coordenadorias regionais de saúde e no Rio Grande do Sul, 2000-2020. Método: Estudo ecológico com dados secundários coletados no Sistema de Informações Hospitalares, Sistema de Informação sobre Mortalidade e Instituto Brasileiro de Geografia e Estatística, de 2000-2020. Foi realizada padronização dos coeficientes pelo método direto e análise por regressão de Prais-Winsten. Resultados: Encontrou-se tendência de diminuição dos coeficientes de internações por diabetes mellitus na maioria dos municípios e Estado. Em 2020, foram observadas hospitalizações por diabetes mellitus abaixo da média obtida no período, para ambos. A tendência de mortalidade permaneceu estacionária em quase todos os municípios e no Estado. Conclusão: Foi evidenciada diminuição das internações e mortalidade estacionária por DM na maioria dos municípios analisados, possivelmente em virtude das políticas e ações implementadas no período, apesar do envelhecimento da população.
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