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Int. J. Environ. Res. Public Health 2018, 15(2), 294; https://doi.org/10.3390/ijerph15020294

Disease and Economic Burden of Hospitalizations Attributable to Diabetes Mellitus and Its Complications: A Nationwide Study in Brazil

1
Internal Medicine Department, State University of Rio de Janeiro, Rio de Janeiro 20551-030, Brazil
2
Social Medicine Department, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre 90035-003, Brazil
3
Biostatistics and Bioinformatics Department, National Institute of Cardiology, Rio de Janeiro 22240-006, Brazil
4
Collective Health Department, Federal University of Goiás, Goiânia 75345-000, Brazil
*
Author to whom correspondence should be addressed.
Received: 16 November 2017 / Revised: 20 January 2018 / Accepted: 1 February 2018 / Published: 8 February 2018
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Abstract

Diabetes is associated with a significant burden globally. The costs of diabetes-related hospitalizations are unknown in most developing countries. The aim of this study was to estimate the total number and economic burden of hospitalizations attributable to diabetes mellitus (DM) and its complications in adults from the perspective of the Brazilian Public Health System in 2014. Data sources included the National Health Survey (NHS) and National database of Hospitalizations (SIH). We considered diabetes, its microvascular (retinopathy, nephropathy, and neuropathy) and macrovascular complications (coronary heart disease, cerebrovascular disease, and peripheral arterial disease), respiratory and urinary tract infections, as well as selected cancers. Assuming that DM patients are hospitalized for these conditions more frequently that non-DM individuals, we estimated the etiological fraction of each condition related to DM, using the attributable risk methodology. We present number, average cost per case, and overall costs of hospitalizations attributable to DM in Brazil in 2014, stratified by condition, state of the country, gender and age group. In 2014, a total of 313,273 hospitalizations due to diabetes in adults were reported in Brazil (4.6% of total adult hospitalization), totaling (international dollar) Int$264.9 million. The average cost of an adult hospitalization due to diabetes was Int$845, 19% higher than hospitalization without DM. Hospitalizations due to cardiovascular diseases related to diabetes accounted for the higher proportion of costs (47.9%), followed by microvascular complications (25.4%) and DM per se (18.1%). Understanding the costs of diabetes and its major complications is crucial to raise awareness and to support the decision-making process on policy implementation, also allowing the assessment of prevention and control strategies. View Full-Text
Keywords: diabetes mellitus; cost and cost analysis; hospitalization; inpatients; health care expenditure; cardiovascular disease; chronic non-communicable disease diabetes mellitus; cost and cost analysis; hospitalization; inpatients; health care expenditure; cardiovascular disease; chronic non-communicable disease
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Quarti Machado Rosa, M.; dos Santos Rosa, R.; Correia, M.G.; Araujo, D.V.; Bahia, L.R.; Toscano, C.M. Disease and Economic Burden of Hospitalizations Attributable to Diabetes Mellitus and Its Complications: A Nationwide Study in Brazil. Int. J. Environ. Res. Public Health 2018, 15, 294.

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