Piropo Thiago Gonçalves do Nascimento, Ramos Francisco de Sousa
Universidade Federal de Pernambuco, Recife, Brasil.
Cad Saude Publica. 2024 Nov 4;40(10):e00088123. doi: 10.1590/0102-311XPT088123. eCollection 2024.
Hospitalization costs due to cardiovascular diseases are high. In 2019, for Bahia State, Brazil, alone, they exceeded BRL 153 million for the Brazilian Unified National Health System, surpassing the costs of cancer hospitalizations. This fact will show an upward trend with the increase in life expectancy in Brazil (7.3 years more by 2060). Introducing new technologies can mitigate the problem. This study analyzes the impact of telediagnostics in electrocardiogram on hospitalizations for cardiovascular diseases in 326 municipalities in Bahia from 2014 to 2020. Diff-in-diff estimator method was used for analysis of the periods before and after the implementation of telediagnostics in Bahia. Results show that the municipalities which introduced the new technology reduced cardiovascular diseases hospitalizations by 6 for each additional year. In the case of families benefiting from the Brazilian Income Transfer Program, the reduction was 3.26 hospitalizations, and 3.08 among municipalities with the specialized service. Hospitalization increase by 7.66 in the 30 to 59 age group and by 5.34 among men for each additional year. Results show a reduction of 1.15 hospitalizations for rheumatologic heart diseases and 1.39 among diabetic people. In terms of ethnicity/color, underreporting was identified in the conditions studied, resulting in more severe prognoses for blacks. Telediagnostics was effective in reducing this inequality by expanding access and reducing hospitalizations, playing a crucial role in public health and impacting mortality reduction. The theme, therefore, deserves further studies with different samples and sample periods.
心血管疾病的住院费用很高。仅在2019年，仅巴西巴伊亚州，巴西统一国家卫生系统的此类费用就超过1.53亿雷亚尔，超过了癌症住院费用。随着巴西预期寿命的增加（到2060年将增加7.3岁），这一情况将呈上升趋势。引入新技术可以缓解这一问题。本研究分析了2014年至2020年远程心电图诊断技术对巴伊亚州326个市心血管疾病住院情况的影响。采用双重差分估计方法分析了巴伊亚州实施远程诊断前后的时期。结果表明，引入新技术的市每增加一年，心血管疾病住院人数减少6例。在受益于巴西收入转移计划的家庭中，住院人数减少3.26例，在设有专门服务的市中减少3.08例。30至59岁年龄组每增加一年住院人数增加7.66例，男性增加5.34例。结果显示，风湿性心脏病住院人数减少1.15例，糖尿病患者减少1.39例。在种族/肤色方面，在所研究的疾病中发现了报告不足的情况，导致黑人的预后更严重。远程诊断通过扩大就医机会和减少住院人数有效地减少了这种不平等，在公共卫生中发挥了关键作用，并对降低死亡率产生了影响。因此，这一主题值得用不同的样本和样本期进行进一步研究。
