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2011 年至 2019 年巴西国家卫生系统中以糖尿病为主要诊断的住院时间趋势和费用。

Time trend and costs of hospitalizations with diabetes mellitus as main diagnosis in the Brazilian National Health System, 2011 to 2019.

机构信息

Universidade do Sul de Santa Catarina, Curso de graduação em Medicina, Tubarão, SC, Brazil.

Pan-American Health Organization, Coordenação de Doenças Crônicas Não Transmissíveis e Saúde Mental, Asunción, Departamento Central, Paraguay.

出版信息

Epidemiol Serv Saude. 2024 Jan 5;32(4):e2023509. doi: 10.1590/S2237-96222023000400006.en. eCollection 2024.

DOI:10.1590/S2237-96222023000400006.en
PMID:38198367
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10768797/
Abstract

OBJECTIVE

To analyze the diabetes mellitus (DM) temporal trend and hospitalization costs in Brazil, by region, Federative Units (FUs) and population characteristics, from 2011 to 2019.

METHODS

This was an ecological study with data from the Hospital Information System, analyzing the annual trend in hospitalization rates for DM according to sex, age, race/skin color and region/FU by Prais-Winsten generalized linear regression.

RESULTS

A total of 1,239,574 DM hospitalizations were recorded in the country and the hospitalization rates was 6.77/10,000 inhabitants in the period. The DM hospitalization rates trend was falling for both sexes and in most regions, while it was rising in the younger population and for length of stay (average 6.17 days). Total expenditure was US$ 420,692.23 and it showed a rising trend.

CONCLUSION

The temporal trend of hospitalization rates due to DM was falling, with differences according to region/FU and age group. Average length of stay and expenditure showed a rising trend.

MAIN RESULTS

From 2011 to 2019, the diabetes mellitus hospitalization rate was 6.77 per 10,000 inhabitants, with a falling trend. Total expenditure was US$420,692.23 and it showed a rising trend.

IMPLICATIONS FOR SERVICES

The study warns of the increase in child and adolescent hospitalizations, which indicates the need to invest in preventive actions and early diagnosis.

PERSPECTIVES

The increase in length of hospital stay and related costs indicates a worrying scenario for the Brazilian National Health System and emphasizes the need to improve access to and quality of care, with a focus on diabetes education, so as to avoid complications and hospitalizations.

摘要

目的

分析 2011 年至 2019 年期间,巴西按地区、联邦单位(FU)和人口特征划分的糖尿病(DM)时间趋势和住院费用。

方法

这是一项基于医院信息系统的生态学研究,通过普赖斯-温斯坦广义线性回归分析,按性别、年龄、种族/肤色和地区/FU 对 DM 住院率的年度趋势进行分析。

结果

全国共记录了 1239574 例 DM 住院病例,住院率为每 10000 名居民 6.77 例。DM 住院率呈下降趋势,男性和女性均呈下降趋势,大多数地区也呈下降趋势,而年轻人群和住院时间(平均 6.17 天)呈上升趋势。总支出为 420692.23 美元,呈上升趋势。

结论

DM 住院率的时间趋势呈下降趋势,不同地区/FU 和年龄组之间存在差异。平均住院时间和支出呈上升趋势。

主要结果

2011 年至 2019 年,糖尿病住院率为每 10000 人 6.77 例,呈下降趋势。总支出为 420692.23 美元,呈上升趋势。

对服务的启示

研究警告说,儿童和青少年住院人数增加,这表明需要投资于预防措施和早期诊断。

展望

住院时间和相关费用的增加表明巴西国家卫生系统的情况令人担忧,这强调了需要改善获得和护理质量,重点是糖尿病教育,以避免并发症和住院治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd90/10768797/fd343f0d7f18/2237-9622-ress-32-04-e2023509-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd90/10768797/df12a2e22642/2237-9622-ress-32-04-e2023509-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd90/10768797/fd343f0d7f18/2237-9622-ress-32-04-e2023509-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd90/10768797/df12a2e22642/2237-9622-ress-32-04-e2023509-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd90/10768797/fd343f0d7f18/2237-9622-ress-32-04-e2023509-f2.jpg

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本文引用的文献

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Cien Saude Colet. 2022 Jul;27(7):2643-2653. doi: 10.1590/1413-81232022277.02572022. Epub 2022 Mar 9.
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Evolution of diabetes in Brazil: prevalence data from the 2013 and 2019 Brazilian National Health Survey.巴西糖尿病的演变:来自2013年和2019年巴西全国健康调查的患病率数据。
Cad Saude Publica. 2022 May 6;38Suppl 1(Suppl 1):e00149321. doi: 10.1590/0102-311X00149321. eCollection 2022.
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The Incidence of Adult-Onset Type 1 Diabetes: A Systematic Review From 32 Countries and Regions.
成人发病型 1 型糖尿病的发病率:来自 32 个国家和地区的系统评价。
Diabetes Care. 2022 Apr 1;45(4):994-1006. doi: 10.2337/dc21-1752.
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Lifetime risk of developing diabetes and years of life lost among those with diabetes in Brazil.巴西糖尿病患者的糖尿病发病终身风险和生命损失年数。
J Glob Health. 2021 Jul 3;11:04041. doi: 10.7189/jogh.11.04041. eCollection 2021.
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Changes in the pattern of health services use in Brazil between 2013 and 2019.2013 年至 2019 年期间巴西卫生服务使用模式的变化。
Cien Saude Colet. 2021 Jun 14;26(suppl 1):2515-2528. doi: 10.1590/1413-81232021266.1.43482020. eCollection 2021.
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The effectiveness of in-hospital interventions on reducing hospital length of stay and readmission of patients with Type 2 Diabetes Mellitus: A systematic review.院内干预措施对降低 2 型糖尿病患者住院时间和再入院率的有效性:系统评价。
Diabetes Res Clin Pract. 2021 Apr;174:108363. doi: 10.1016/j.diabres.2020.108363. Epub 2020 Aug 6.
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DIABETIC KETOACIDOSIS AS THE INITIAL PRESENTATION OF TYPE 1 DIABETES IN CHILDREN AND ADOLESCENTS: EPIDEMIOLOGICAL STUDY IN SOUTHERN BRAZIL.糖尿病酮症酸中毒作为儿童和青少年1型糖尿病的首发表现:巴西南部的流行病学研究
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Disease and Economic Burden of Hospitalizations Attributable to Diabetes Mellitus and Its Complications: A Nationwide Study in Brazil.糖尿病及其并发症导致的住院疾病负担和经济负担:巴西全国性研究。
Int J Environ Res Public Health. 2018 Feb 8;15(2):294. doi: 10.3390/ijerph15020294.
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Effectiveness of diabetes education and awareness of diabetes mellitus in combating diabetes in the United Kigdom; a literature review.糖尿病教育及对糖尿病的认知在英国对抗糖尿病中的有效性;一项文献综述。
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Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control.住院患者糖尿病教育与血糖控制不佳患者的住院频率降低有关。
Diabetes Care. 2013 Oct;36(10):2960-7. doi: 10.2337/dc13-0108. Epub 2013 Jul 8.