Análise dos gastos hospitalares e ambulatoriais do Sistema Único de Saúde e Previdenciários do Regime Geral de Previdência Social do acidente vascular cerebral no Brasil

Abstract

Stroke is a disease that causes great morbidity and mortality and socioeconomic impact in Brazil. The objective was to analyze inpatiet and outpatient expenses from Unified Health System and social security expenses from General Social Security for stroke in Brazil, between 2010 and 2019. Observational and descriptive research that analyzed a historical series of secondary data from the Hospital and Outpatient Information System of the Unified Health System, with access to Tabwin and social security benefits from the General Social Security, obtained from the Database Historical Social Security Data, online, between 2010 and 2019. Expenses were presented in reais (R$), adjusted for inflation for 2019, including all inpatient and outpatient procedures and social security benefits granted according to code I-64 (stroke not specified as hemorrhagic or ischemic), above the 18 years of age, for male and female. Total expenses were formed by the sum of inpatient, outpatient and social security expenses. Statistical tests were used to analyze the results. The total expense of stroke for the public system was higher due to hospital expenses (89%, 96% of which consisted of clinical procedures), social security expenses (6%, of which 99% consisted of disability retirement and sickness benefits) and outpatient expenses. (5%, 61% of which were formed by diagnostic imaging exams). There was an increase in hospital expenses (17%), social security expenses (50%) and a decrease in outpatient expenses (-37%). Positive correlations were found with the Gross Domestic Product per capita (r= .784; p<0.05) and the elderly population (r= .676; p<0.05). Stroke generated more inpatient expenses, due to the clinical profile of the disease, followed by social security and outpatient expenses, suggesting that it is a disease that burdens the public system and removes the workforce from society.. Therefore, we can suggest that in order to reduce public system spending, measures that combat modifiable risk factors must be intensified, since the country's demographic trend is towards an increase in the elderly population, a strong non-modifiable risk factor for stroke, which will continue to increase in the coming years in Brazil.