O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Estudos Econômicos (São Paulo) |
Texto Completo: | https://www.revistas.usp.br/ee/article/view/43434 |
Resumo: | Health care spending projections point to a considerable increase in expenditure due to population aging. However, studies show that healthcare spending is concentrated at the end of life. Therefore, expenditure projections that do not take proximity to death into account tend to be overestimated. The aim of this paper is to analyze the amount of spending on public inpatient care in Brazil by survivorship status and determine if there is a relationship between inpatient costs for individuals close to death and age at death. We used data about hospital admissions over the years 1995 to 2007 from Sistema de Informações Hospitalares do Sistema Único de Saúde – SIH/SUS (Hospital System Information from Unified Health System), an administrative record from the federal government that includes information on all public hospitalizations in Brazil. Survivorship status is given by those who survived in the year of analysis (survivors) and for those who died in the same period (decedents). We analyzed inpatient expenditure trends over time by age group for survivors and decedents, and the ratio of decedents/ survivors costs. Projections of inpatient expenditures in 2050were performed by the multiplication of per capita inpatient costs by age by the projected number of hospitalizations in each age group. In order to analyze the effect of survival status on hospital spending, we first estimated the number of decedents and survivors in each age group in the future, and then we multiplied these numbers through the per capita expenditure by survivorship status and age. The results show that the pattern of expenditure by survivorship status in Brazil follows the pattern found in other countries: for survivors expenditures increase with age and for decedents there is a downward trend by age. The ratio decedents/survivors cost has a negative relationship with age but increases over time. Applying the age profile of the average expenditure for 2007 results in a projected increase of over 380% in spending on hospital admissions in 2050. But when expenditures are projected by survivorship status, the growth is no more than 70%. A backward projection for 2007 shows the effect of ageing is lower when the effect of proximity to death is accounted for. |
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O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporalThe effect of survivorship status on public inpatient expenditures in Brazil in a temporal perspectivepublic inpatient care spendingsurvivorship statusBrazilgastos com internação hospitalarstatus de sobrevivênciaBrasilHealth care spending projections point to a considerable increase in expenditure due to population aging. However, studies show that healthcare spending is concentrated at the end of life. Therefore, expenditure projections that do not take proximity to death into account tend to be overestimated. The aim of this paper is to analyze the amount of spending on public inpatient care in Brazil by survivorship status and determine if there is a relationship between inpatient costs for individuals close to death and age at death. We used data about hospital admissions over the years 1995 to 2007 from Sistema de Informações Hospitalares do Sistema Único de Saúde – SIH/SUS (Hospital System Information from Unified Health System), an administrative record from the federal government that includes information on all public hospitalizations in Brazil. Survivorship status is given by those who survived in the year of analysis (survivors) and for those who died in the same period (decedents). We analyzed inpatient expenditure trends over time by age group for survivors and decedents, and the ratio of decedents/ survivors costs. Projections of inpatient expenditures in 2050were performed by the multiplication of per capita inpatient costs by age by the projected number of hospitalizations in each age group. In order to analyze the effect of survival status on hospital spending, we first estimated the number of decedents and survivors in each age group in the future, and then we multiplied these numbers through the per capita expenditure by survivorship status and age. The results show that the pattern of expenditure by survivorship status in Brazil follows the pattern found in other countries: for survivors expenditures increase with age and for decedents there is a downward trend by age. The ratio decedents/survivors cost has a negative relationship with age but increases over time. Applying the age profile of the average expenditure for 2007 results in a projected increase of over 380% in spending on hospital admissions in 2050. But when expenditures are projected by survivorship status, the growth is no more than 70%. A backward projection for 2007 shows the effect of ageing is lower when the effect of proximity to death is accounted for.As projeções de gastos com saúde apontam para um crescimento considerável das despesas em decorrência do envelhecimento populacional. No entanto, estudos mostram que os gastos se concentram no fim da vida e, dessa forma, projeções que não levam em conta variáveis de proximidade à morte tendem a superestimar as projeções. O objetivo deste trabalho é analisar a magnitude dos gastos com internações públicas no Brasil por status de sobrevivência, e identificar se existe uma relação entre despesas com internações para indivíduos próximos à morte e idade à morte. O banco de dados empregado é oriundo do Sistema de Informações Hospitalares do DATASUS – SIH/DATASUS – para o período de 1995 a 2007 no Brasil. Foi analisada a evolução dos gastos totais e a tendência dos gastos por grupo etário para aqueles pacientes que tiveram como motivo de saída do hospital a alta (sobreviventes) ou o óbito (pacientes terminais). A fim de analisar o efeito do status de sobrevivência sobre os gastos com internações no futuro, simulamos projeções de gastos em 2050, desagregados entre gastos de sobreviventes e gastos relacionados à morte. Os resultados mostram que o padrão de gastos por status de sobrevivência no Brasil é crescente por grupo etário para o grupo de sobreviventes, e decrescente para os indivíduos que faleceram. Também se verificou que a razão de gastos mortos/sobreviventes diminui com a idade. A simulação da projeção de gastos com internações para 2050 mostra que quando se considera apenas o perfil etário dos gastos médios em 2007, há um crescimento de mais de 380% nos gastos com internações em 2050 quando comparado a 2007, mas quando os gastos são projetados segundo o status de sobrevivência, o crescimento não passa de 70%. Projeção retrospectiva para 2007 mostra que o efeito do envelhecimento é menor quando o efeito da proximidade à morte é levado em consideração.Universidade de São Paulo. Faculdade de Economia, Administração e Contabilidade2012-09-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/ee/article/view/43434Estudos Econômicos (São Paulo); v. 42 n. 3 (2012); 489-5101980-53570101-4161reponame:Estudos Econômicos (São Paulo)instname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/ee/article/view/43434/47056Copyright (c) 2012 Cristina Guimarães Rodrigues, Luís Eduardo Afonsohttp://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessRodrigues, Cristina GuimarãesAfonso, Luís Eduardo2020-12-10T19:52:28Zoai:revistas.usp.br:article/43434Revistahttps://www.revistas.usp.br/eePUBhttps://www.revistas.usp.br/ee/oaiestudoseconomicos@usp.br||aldrighi@usp.br1980-53570101-4161opendoar:2020-12-10T19:52:28Estudos Econômicos (São Paulo) - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal The effect of survivorship status on public inpatient expenditures in Brazil in a temporal perspective |
title |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal |
spellingShingle |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal Rodrigues, Cristina Guimarães public inpatient care spending survivorship status Brazil gastos com internação hospitalar status de sobrevivência Brasil |
title_short |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal |
title_full |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal |
title_fullStr |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal |
title_full_unstemmed |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal |
title_sort |
O efeito do status de sobrevivência sobre gastos com internações hospitalares públicas no Brasil em uma perspectiva temporal |
author |
Rodrigues, Cristina Guimarães |
author_facet |
Rodrigues, Cristina Guimarães Afonso, Luís Eduardo |
author_role |
author |
author2 |
Afonso, Luís Eduardo |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Rodrigues, Cristina Guimarães Afonso, Luís Eduardo |
dc.subject.por.fl_str_mv |
public inpatient care spending survivorship status Brazil gastos com internação hospitalar status de sobrevivência Brasil |
topic |
public inpatient care spending survivorship status Brazil gastos com internação hospitalar status de sobrevivência Brasil |
description |
Health care spending projections point to a considerable increase in expenditure due to population aging. However, studies show that healthcare spending is concentrated at the end of life. Therefore, expenditure projections that do not take proximity to death into account tend to be overestimated. The aim of this paper is to analyze the amount of spending on public inpatient care in Brazil by survivorship status and determine if there is a relationship between inpatient costs for individuals close to death and age at death. We used data about hospital admissions over the years 1995 to 2007 from Sistema de Informações Hospitalares do Sistema Único de Saúde – SIH/SUS (Hospital System Information from Unified Health System), an administrative record from the federal government that includes information on all public hospitalizations in Brazil. Survivorship status is given by those who survived in the year of analysis (survivors) and for those who died in the same period (decedents). We analyzed inpatient expenditure trends over time by age group for survivors and decedents, and the ratio of decedents/ survivors costs. Projections of inpatient expenditures in 2050were performed by the multiplication of per capita inpatient costs by age by the projected number of hospitalizations in each age group. In order to analyze the effect of survival status on hospital spending, we first estimated the number of decedents and survivors in each age group in the future, and then we multiplied these numbers through the per capita expenditure by survivorship status and age. The results show that the pattern of expenditure by survivorship status in Brazil follows the pattern found in other countries: for survivors expenditures increase with age and for decedents there is a downward trend by age. The ratio decedents/survivors cost has a negative relationship with age but increases over time. Applying the age profile of the average expenditure for 2007 results in a projected increase of over 380% in spending on hospital admissions in 2050. But when expenditures are projected by survivorship status, the growth is no more than 70%. A backward projection for 2007 shows the effect of ageing is lower when the effect of proximity to death is accounted for. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-09-30 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/ee/article/view/43434 |
url |
https://www.revistas.usp.br/ee/article/view/43434 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/ee/article/view/43434/47056 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2012 Cristina Guimarães Rodrigues, Luís Eduardo Afonso http://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2012 Cristina Guimarães Rodrigues, Luís Eduardo Afonso http://creativecommons.org/licenses/by-nc/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Economia, Administração e Contabilidade |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Economia, Administração e Contabilidade |
dc.source.none.fl_str_mv |
Estudos Econômicos (São Paulo); v. 42 n. 3 (2012); 489-510 1980-5357 0101-4161 reponame:Estudos Econômicos (São Paulo) instname:Universidade de São Paulo (USP) instacron:USP |
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Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Estudos Econômicos (São Paulo) |
collection |
Estudos Econômicos (São Paulo) |
repository.name.fl_str_mv |
Estudos Econômicos (São Paulo) - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
estudoseconomicos@usp.br||aldrighi@usp.br |
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1787713829151440896 |