Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1590/1516-3180.2021.0496.23072021 http://hdl.handle.net/1843/54671 https://orcid.org/0000-0001-5240-0493 https://orcid.org/0000-0002-9623-3305 https://orcid.org/0000-0003-2016-5593 https://orcid.org/0000-0001-9709-8865 https://orcid.org/0000-0002-3387-3583 |
Resumo: | BACKGROUND: Multiple opinion-based communications have highlighted the actions of the Brazilian government during the pandemic. Nevertheless, none have appraised public data to identify factors associated with worsening of the healthcare system. OBJECTIVE: To analyze and collate data from public health and treasury information systems in order to understand the escalating process of weakening of Brazilian healthcare and welfare since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. DESIGN AND SETTING: Secondary data study conducted using multiple public databases administered by the Brazilian federal government. METHODS: We processed information from multiple national databases and appraised health and economic-related data. RESULTS: Based on our analyses, there were substantial reductions in inpatient hospital admissions and in the numbers of patients seeking primary care services, along with a decrease in immunization coverage. Moreover, we observed a considerable decline in government transfers to hospital services (reduction of 82.0%) and a diminution of public outlays in several healthcare-related subfunctions (“hospital and outpatient care”, “primary care”, “prophylactic and therapeutic support” and “epidemiological surveillance”). We observed an increase in the overall mortality rate over the period analyzed, especially regarding all group-based diseases. Notably, there were remarkable differences among geographic, racial, gender and other parameters, thus revealing the impact of vulnerabilities on COVID-19 outcomes. CONCLUSION: This assessment of documentation of public expenditure and the shrinkage of investment in sensitive areas of the healthcare system in Brazil emphasized areas that still require collective attention in order to guarantee national welfare. |
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2023-06-07T19:44:10Z2023-06-07T19:44:10Z20221402290296https://doi.org/10.1590/1516-3180.2021.0496.230720211806-9460http://hdl.handle.net/1843/54671https://orcid.org/0000-0001-5240-0493https://orcid.org/0000-0002-9623-3305https://orcid.org/0000-0003-2016-5593https://orcid.org/0000-0001-9709-8865https://orcid.org/0000-0002-3387-3583BACKGROUND: Multiple opinion-based communications have highlighted the actions of the Brazilian government during the pandemic. Nevertheless, none have appraised public data to identify factors associated with worsening of the healthcare system. OBJECTIVE: To analyze and collate data from public health and treasury information systems in order to understand the escalating process of weakening of Brazilian healthcare and welfare since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. DESIGN AND SETTING: Secondary data study conducted using multiple public databases administered by the Brazilian federal government. METHODS: We processed information from multiple national databases and appraised health and economic-related data. RESULTS: Based on our analyses, there were substantial reductions in inpatient hospital admissions and in the numbers of patients seeking primary care services, along with a decrease in immunization coverage. Moreover, we observed a considerable decline in government transfers to hospital services (reduction of 82.0%) and a diminution of public outlays in several healthcare-related subfunctions (“hospital and outpatient care”, “primary care”, “prophylactic and therapeutic support” and “epidemiological surveillance”). We observed an increase in the overall mortality rate over the period analyzed, especially regarding all group-based diseases. Notably, there were remarkable differences among geographic, racial, gender and other parameters, thus revealing the impact of vulnerabilities on COVID-19 outcomes. CONCLUSION: This assessment of documentation of public expenditure and the shrinkage of investment in sensitive areas of the healthcare system in Brazil emphasized areas that still require collective attention in order to guarantee national welfare.CONTEXTO: Múltiplas comunicações baseadas em opinião têm destacado as ações do governo brasileiro durante a pandemia. No entanto, nenhum deles avaliou dados públicos para identificar fatores associados à piora do sistema de saúde. OBJETIVO: Analisar e cotejar dados dos sistemas de informação da saúde pública e do tesouro para entender o processo crescente de fragilização da saúde e da previdência brasileira desde o início da pandemia do coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2). DESENHO E LOCAL: Estudo de dados secundários conduzido em vários bancos de dados públicos administrados pelo governo federal brasileiro. MÉTODOS: Processamos informações de vários bancos de dados nacionais e avaliamos dados relacionados à saúde e à economia. RESULTADOS: Com base em nossas análises, houve reduções substanciais nas internações hospitalares e no número de pacientes que procuram serviços de atenção primária, juntamente com uma diminuição na cobertura de imunização. Além disso, observamos uma queda considerável nas transferências do governo para serviços hospitalares (redução de 82,0%) e diminuição dos gastos públicos em diversas subfunções relacionadas à saúde (“assistência hospitalar e ambulatorial”, “atenção básica”, “apoio profilático e terapêutico” e “vigilância epidemiológica”). Observou-se aumento da taxa de mortalidade geral ao longo do período analisado, principalmente em relação a todas as doenças grupais. Notavelmente, houve diferenças notáveis entre parâmetros geográficos, raciais, de gênero e outros, revelando assim o impacto das vulnerabilidades nos resultados do COVID-19. CONCLUSÃO: A avaliação da documentação do gasto público e a redução do investimento em áreas sensíveis do sistema de saúde no Brasil enfatizam áreas que ainda requerem atenção coletiva para garantir o bem-estar nacional.engUniversidade Federal de Minas GeraisUFMGBrasilHCL - HOSPITAL DAS CLINICASICB - DEPARTAMENTO DE FISIOLOGIA E BIOFÍSICAMED - DEPARTAMENTO DE CLÍNICA MÉDICAMED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIALSão Paulo Medical JournalCOVID-19 (Doença)COVID-19 Pandemia, 2020Administração em saúde públicaGerenciamento de dadosGastos públicos com saúdeDisparidades em assistência à saúdeHospitalizaçãoMortalidadeBrasilSARS-CoV-2BrazilPublic HealthData ManagementHealth ExpendituresInequalityHospitalizationAll-cause mortalityCOVID-19 crisisHospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlightHospitalização, mortalidade e saúde pública gastos no Brasil durante a crise do COVID-19: vulnerabilidades em destaqueinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://www.scielo.br/j/spmj/a/FxSrCtvSqBzLqcQr3Pz4pWv/?lang=enIsrael Júnior Borges do NascimentoAna Luíza Matos de OliveiraPaulo Henrique Costa DinizMaria de Fátima LeiteGraziella Lage Oliveiraapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/54671/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALHospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis vulnerabilities in the spotlight.pdfHospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis vulnerabilities in the spotlight.pdfapplication/pdf360455https://repositorio.ufmg.br/bitstream/1843/54671/2/Hospitalization%2c%20mortality%20and%20public%20healthcare%20expenditure%20in%20Brazil%20during%20the%20COVID-19%20crisis%20vulnerabilities%20in%20the%20spotlight.pdfc1a081acbf77843d9d9295bc49eb17ecMD521843/546712023-06-07 16:44:10.982oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-06-07T19:44:10Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight |
dc.title.alternative.pt_BR.fl_str_mv |
Hospitalização, mortalidade e saúde pública gastos no Brasil durante a crise do COVID-19: vulnerabilidades em destaque |
title |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight |
spellingShingle |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight Israel Júnior Borges do Nascimento SARS-CoV-2 Brazil Public Health Data Management Health Expenditures Inequality Hospitalization All-cause mortality COVID-19 crisis COVID-19 (Doença) COVID-19 Pandemia, 2020 Administração em saúde pública Gerenciamento de dados Gastos públicos com saúde Disparidades em assistência à saúde Hospitalização Mortalidade Brasil |
title_short |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight |
title_full |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight |
title_fullStr |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight |
title_full_unstemmed |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight |
title_sort |
Hospitalization, mortality and public healthcare expenditure in Brazil during the COVID-19 crisis: vulnerabilities in the spotlight |
author |
Israel Júnior Borges do Nascimento |
author_facet |
Israel Júnior Borges do Nascimento Ana Luíza Matos de Oliveira Paulo Henrique Costa Diniz Maria de Fátima Leite Graziella Lage Oliveira |
author_role |
author |
author2 |
Ana Luíza Matos de Oliveira Paulo Henrique Costa Diniz Maria de Fátima Leite Graziella Lage Oliveira |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Israel Júnior Borges do Nascimento Ana Luíza Matos de Oliveira Paulo Henrique Costa Diniz Maria de Fátima Leite Graziella Lage Oliveira |
dc.subject.por.fl_str_mv |
SARS-CoV-2 Brazil Public Health Data Management Health Expenditures Inequality Hospitalization All-cause mortality COVID-19 crisis |
topic |
SARS-CoV-2 Brazil Public Health Data Management Health Expenditures Inequality Hospitalization All-cause mortality COVID-19 crisis COVID-19 (Doença) COVID-19 Pandemia, 2020 Administração em saúde pública Gerenciamento de dados Gastos públicos com saúde Disparidades em assistência à saúde Hospitalização Mortalidade Brasil |
dc.subject.other.pt_BR.fl_str_mv |
COVID-19 (Doença) COVID-19 Pandemia, 2020 Administração em saúde pública Gerenciamento de dados Gastos públicos com saúde Disparidades em assistência à saúde Hospitalização Mortalidade Brasil |
description |
BACKGROUND: Multiple opinion-based communications have highlighted the actions of the Brazilian government during the pandemic. Nevertheless, none have appraised public data to identify factors associated with worsening of the healthcare system. OBJECTIVE: To analyze and collate data from public health and treasury information systems in order to understand the escalating process of weakening of Brazilian healthcare and welfare since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. DESIGN AND SETTING: Secondary data study conducted using multiple public databases administered by the Brazilian federal government. METHODS: We processed information from multiple national databases and appraised health and economic-related data. RESULTS: Based on our analyses, there were substantial reductions in inpatient hospital admissions and in the numbers of patients seeking primary care services, along with a decrease in immunization coverage. Moreover, we observed a considerable decline in government transfers to hospital services (reduction of 82.0%) and a diminution of public outlays in several healthcare-related subfunctions (“hospital and outpatient care”, “primary care”, “prophylactic and therapeutic support” and “epidemiological surveillance”). We observed an increase in the overall mortality rate over the period analyzed, especially regarding all group-based diseases. Notably, there were remarkable differences among geographic, racial, gender and other parameters, thus revealing the impact of vulnerabilities on COVID-19 outcomes. CONCLUSION: This assessment of documentation of public expenditure and the shrinkage of investment in sensitive areas of the healthcare system in Brazil emphasized areas that still require collective attention in order to guarantee national welfare. |
publishDate |
2022 |
dc.date.issued.fl_str_mv |
2022 |
dc.date.accessioned.fl_str_mv |
2023-06-07T19:44:10Z |
dc.date.available.fl_str_mv |
2023-06-07T19:44:10Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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http://hdl.handle.net/1843/54671 |
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https://doi.org/10.1590/1516-3180.2021.0496.23072021 |
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1806-9460 |
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https://orcid.org/0000-0001-5240-0493 https://orcid.org/0000-0002-9623-3305 https://orcid.org/0000-0003-2016-5593 https://orcid.org/0000-0001-9709-8865 https://orcid.org/0000-0002-3387-3583 |
url |
https://doi.org/10.1590/1516-3180.2021.0496.23072021 http://hdl.handle.net/1843/54671 https://orcid.org/0000-0001-5240-0493 https://orcid.org/0000-0002-9623-3305 https://orcid.org/0000-0003-2016-5593 https://orcid.org/0000-0001-9709-8865 https://orcid.org/0000-0002-3387-3583 |
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1806-9460 |
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eng |
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São Paulo Medical Journal |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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Universidade Federal de Minas Gerais |
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