Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
Núcleo de Pesquisa em Ortopedia e Traumatologia, Hospital e Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brazil.
Einstein (Sao Paulo). 2021 Dec 10;19:eGS5625. doi: 10.31744/einstein_journal/2021GS5625. eCollection 2021.
To describe and analyze the epidemiology and costs of surgical treatment of hip dysplasia in the Brazilian Public Health System.
An ecological analytical study that evaluated a time series and the geographic distribution of surgical treatment of hip dysplasia in Brazil. Frequencies of cases, number of cases and associated factors were analyzed. Correlations, frequency maps and flow maps are presented and discussed.
During the study, 14,584 patients with dysplasia were admitted to hospitals according to Information Technology Department of the Public Health System. Patients underwent hospital treatment specific for dysplasia in 8,592 cases (at an average cost of R$ 2.225,50, total cost of R$ 19.124.086,25- updated values). In this group, mortality rate was 0.046% and mean hospitalization time was 4.41 days (standard deviation of 2,39 days). Age between 1 and 4 years (37.7%), female sex (64.5%) and white race (46%) were more frequent. Greater rates of specialists (R²=0.82; p<0.001), greater proportion of counties with high/very high human development index (R²=0.79; p<0.001), and higher per capita income (R²=0.68; p<0.001) correlated to greater rates of treatments undertaken per 1,000 live births (as per State of treatment). The factor most related to treatment rate per 1,000 live births (as per State of residence) was white race (R²=0.90; p<0.001). Southern states had higher treatment rates (as per State of residence, rate of 0.73/1,000), and Southeast states had greater absolute frequency of cases (46.7%) and greater flow of patients.
The surgical treatment of hip dysplasia in Brazil occurs frequently, at relevant costs, and is distributed in a heterogenous and unequal fashion in the Public Health System. Southern states have a higher incidence of cases, and there is an association with racial and socioeconomic factors. There was no large variation in the incidence of cases over time.
描述和分析巴西公立医疗体系中髋关节发育不良的手术治疗的流行病学和费用情况。
本研究为生态分析研究，评估了巴西髋关节发育不良手术治疗的时间序列和地理分布。分析了病例的频率、病例数量和相关因素。展示和讨论了相关性、频率图和流程图。
在研究期间，根据公共卫生系统信息技术部门的记录，有 14584 名患有发育不良的患者入院。8592 例患者接受了针对发育不良的医院治疗（平均费用为 2.22550 雷亚尔，总费用为 191240862.50 雷亚尔-更新值）。在该组中，死亡率为 0.046%，平均住院时间为 4.41 天（标准差为 2.39 天）。年龄在 1 至 4 岁（37.7%）、女性（64.5%）和白种人（46%）更为常见。专家比例较高（R²=0.82；p<0.001）、高/极高人类发展指数县的比例较高（R²=0.79；p<0.001）以及人均收入较高（R²=0.68；p<0.001）与每千例活产的治疗率较高相关（按治疗州划分）。与每千例活产的治疗率最相关的因素是白种人（R²=0.90；p<0.001）。南部各州的治疗率较高（按居住州划分，为 0.73/1000），东南部各州的病例绝对数量较多（46.7%），患者流量较大。
巴西公立医疗体系中髋关节发育不良的手术治疗较为常见，费用较高，分布不均。南部各州的病例发生率较高，与种族和社会经济因素有关。病例发生率在时间上没有大的变化。
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