Distribuição espaço-temporal dos atendimentos e gastos ambulatoriais da incontinência urinária em homens no Brasil

Abstract

Introduction: urinary incontinence is defined as the involuntary loss of urine and males are frequently affected by the disease. It is a pathology that requires treatment and for this there are several therapeutic options. Pelvic physiotherapy acts as a conservative treatment of major importance and are developed at the Unified Health System outpatient level. It is an effective and low-cost strategy for the care of people with urinary incontinence. The loss of continence is a public health problem, generating individual and public power expenses. Objectives: to analyze the outpatient procedures and expenditures of the Unified Health System with urinary incontinence in men in Brazil and regions, between years 2010-2019. Methods: It is an ecological time-series study, along with a spatial distribution of outpatient production for urinary incontinence in men for the North, Northeast, South, Southeast and Midwest regions of Brazil in the period from 2010 to 2019. The data were obtained from the Unified Health System Outpatient Information System. For the analysis of the time trend in the period 2010-2019, the Prais-Winsten method was applied, and for the forecast of the series until 2024, the Integrated Autoregressive Moving Averages model was used. The values spent were described by absolute and relative frequencies in a table of the Statistical Package for the Social Sciences program. Averages were calculated using the data with a 95% confidence interval. Descriptive spatial distribution was performed to verify the spatial distribution of the outpatient production rate of urinary incontinence in men for all regions of Brazil. Results: there were 3,457 outpatient procedures for urinary incontinence in men in 2010, up to 16,765 in 2019, observing an increasing time trend in Brazil, with an annual percentage variation of 50.37% and a 95% confidence interval (37.54% to 63.62%). And, a growth forecast between the years 2020-2024, by the final Autoregressive Integrated Moving Averages (1, 1, 0) model. The average public expenditure on outpatient production for urinary incontinence in men was R$92,141.00 per year, with an increase of 590% observed between 2010 and 2019. The South region had the highest of procedures expenditures when compared to the Midwest region and the age group between 60 and 69 years had the largest economic impact for the public health system. The highest frequency of outpatient procedures for urinary incontinence in men occurred in the Southeast region (71%) and lowest in the North region (2%). Conclusion: there was an increasing time trend of outpatient production for urinary incontinence in men in Brazil between 2010-2019 and with a forecast of growth until 2024. The highest rates occurred in the Southeast region and the greatest increase in the South region, showing a disparity of outpatient care in Brazilian regions. There was a concentration of outpatient spending in geographic regions with better infrastructure, associated with population aging. Thus, the need for prevention and treatment actions for this pathology that meet the needs and specificities of the male population.