Os efeitos de idade e proximidade à morte sobre os gastos com internação no SUS: evidências com base no caso de Minas Gerais, 2004/2005

Abstract

The accelerated aging process that has marked the Brazilian population dynamics in recent decades brings with it enormous challenges related to the (re) direction of public policy. One of the sectors where this debate is more intriguing is the health, due to either changes in demand for services caused by the epidemiological transition, coupled with the increased longevity of the population, or the increasing spending on health. This issue is even more compelling in the perspective of universal services and the challenge of its public funding.In Brazil, the issue of rising health care costs still can not be analyzed in a consistent manner, because of the lack of databases that provide the necessary information. In this thesis, the alternative was to focus on the cost of hospitalization in the Public Health Care System (SUS), taking as universe of research the experience of the state of Minas Gerais (Brazil) in the biennium 2004/2005. The objective was to evaluate whether the cost of hospitalization are related to age or proximity to death. The data are from the Hospital Information System (SIH-SUS). The method used was multiple linear regression, to describe the relationship between the variables investigated (age, sex, length of stay in hospital, survival status and proximity to death) and cost of hospitalization.The results showed that there is a difference in the cost of hospitalization between those who survived and those who died, even when controlling for variables such as number of admissions. Similar results were also reported by studies conducted in the United States and Europe. It was found that the cost of hospitalization in the Public Health Care System in the state of Minas Gerais, in the 2004/2005 period, are explained by factors other than age, with emphasis on the effects of proximity to death and the length of stay in hospital. The closer the month of death, the more expensive it tends to be the cost of hospitalization and the effect of proximity to death is higher among people at younger ages. Thus, policies aimed at health promotion may have a beneficial effect for both the population health and to health spending, delaying the age at death and prolonging the period of healthy life.