Guedes L F F, Vegi A S F, Felisbino-Mendes M S, Menezes M C, Meireles A L, Malta D C, Machado Í E
Universidade Federal de Ouro Preto, Postgraduate Program in Health and Nutrition, Ouro Preto, Minas Gerais, Brazil.
Universidade Federal de Minas Gerais, Postgraduate Program in Nursing, Department of Maternal and Child Nursing and Public Health, Belo Horizonte, Minas Gerais, Brazil.
Public Health. 2024 Mar;228:178-185. doi: 10.1016/j.puhe.2024.01.002. Epub 2024 Feb 19.
OBJECTIVES: This study aimed to estimate the economic costs of excessive sodium consumption in terms of hospitalizations and outpatient procedures of medium and high complexity (OPMHC) for the Brazilian Unified Health System (SUS) and its states in 2019. STUDY DESIGN: Ecological study. METHOD: This study used population attributable fractions (PAFs) of excessive sodium consumption estimated by the Global Burden of Disease study based on the theoretical minimum risk exposure level (3 g of sodium per day), the average population consumption, and relative risks of sodium-outcome pairs. PAFs were applied to the total costs of hospitalizations and OPMHC paid by SUS for each outcome obtained from the Outpatient and Hospital Information Systems. The costs per 10,000 inhabitants in all the Brazilian states were calculated and converted into international dollars (Int$), considering the purchasing parity power in the year 2019. RESULTS: Excessive sodium consumption resulted in Int$ 98,882,386.36 (95% uncertainty interval: Int$ 3,398,343.53-312,065,319.80) in hospitalizations and OPMHC costs in Brazil in 2019. Males and the 55- to 69-year-old age group had the highest expenditures attributable to excessive sodium consumption. Cardiovascular diseases were the most significant contributors to the costs associated with the risk factor. Southern and southeastern states had the highest costs of diseases attributable to sodium. CONCLUSION: Excessive sodium consumption has a significant economic burden on SUS, particularly among men and more developed states. This underscores the inequalities in socio-economic factors and access to health services throughout the country. Economic analyses at the subnational level can provide evidence for public policy planning to define the most appropriate actions for the population's sociodemographic reality.
目的:本研究旨在估算2019年巴西统一卫生系统(SUS)及其各州因钠摄入过量导致的中高复杂度住院和门诊手术(OPMHC)的经济成本。 研究设计:生态研究。 方法:本研究使用了全球疾病负担研究基于理论最低风险暴露水平(每天3克钠)、人群平均消费量以及钠与结局对的相对风险估算的钠摄入过量人群归因分数(PAF)。PAF应用于从门诊和医院信息系统获得的每个结局的SUS支付的住院和OPMHC总成本。计算了巴西所有州每10000居民的成本,并根据2019年的购买力平价转换为国际美元(Int$)。 结果:2019年,钠摄入过量在巴西导致的住院和OPMHC成本为98882386.36国际美元(95%不确定区间:3398343.53 - 312065319.80国际美元)。男性以及55至69岁年龄组因钠摄入过量导致的支出最高。心血管疾病是与该风险因素相关成本的最重要贡献因素。南部和东南部各州因钠导致的疾病成本最高。 结论:钠摄入过量给SUS带来了巨大的经济负担,尤其是在男性和较发达的州。这凸显了全国社会经济因素和获得卫生服务机会方面的不平等。国家以下层面的经济分析可为公共政策规划提供证据,以确定针对人群社会人口现实的最适当行动。
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