Cerebrovascular accidents (CVAs) and diseases of the urinary tract and kidneys are the main causes of hospitalizations considered preventable in the country, according to a survey.
In 2021, while hospitalizations for strokes accounted for 20.11%, those caused by kidney and urinary tract infections reached 17.44%.
Next, hospitalizations for coronary artery disease or angina (8.25%), infectious gastroenteritis (7.63%) and heart failure (6.85%) were the main causes of avoidable hospitalizations in the last year. Other causes still correspond to 12.75%.
The data are from a survey by Unidas (National Union of Self-Management Institutions in Health) carried out with 56 self-management health operators, which serve the main supplementary health plans in the country. The data were collected in two moments, in 2020 and in 2021, totaling more than 2.6 million beneficiaries of the plans, which represent more than 80% of the total operators in the country.
The survey, which is carried out annually, manages to indicate trends in potentially avoidable hospitalizations, as they might not be necessary in the face of prevention and protection actions in primary care.
The indicator is used internationally as a criterion for diseases that have risk factors that can be circumvented, usually associated with lifestyle habits, such as sedentary lifestyle, smoking, consumption of low nutritional value foods and alcohol.
According to Anderson Mendes, president of Unidas, the 2021 data already suggest how the Covid-19 pandemic has impacted health care. As consultations and elective exams were dammed, many of the procedures performed were already in a context of greater severity, which is why there was an increase in potentially avoidable hospitalizations.
“The pandemic meant that self-managers needed to actively search, go after patients, because they stopped looking. And this was actually reflected in an increase in these preventable diseases, also recorded by the increase in emergency room visits”, he says.
Other surveys and studies have shown how the pandemic caused a damming of more than 1 million consultations in the SUS (Unified Health System) and also increased the share of the population living with the so-called NCDs (non-communicable diseases), which include diabetes, hypertension , obesity and cardiovascular disease.
Indicators from the latest Vigitel 2021 survey point to at least 9% of the Brazilian adult population living with diabetes, a jump of 11.7% compared to the previous year. In addition to diabetes, the pandemic has caused a 41% increase in depression diagnoses.
According to data from the Unidas survey, primary health care can contribute to the reduction of such indicators and unnecessary visits to hospital environments. “Everyone wins with the adoption of primary health care programs. Both the plans, which reduce expenses, since hospitalizations represent about 50% of the sector’s costs, and the beneficiaries, who can have a healthier life with quality and targeted follow-up”, says Mendes.
Mendes also reports that, although a year is a relatively short time to attribute this change in trend to the context of the pandemic, data from 2022 can help point in that direction.
“We are already collecting data with the self-managers to assess, in up to five or six months, that is, until the first half of 2023, how hospitalizations for diseases dammed up in the last two years may have acted”, he explains.
The survey, which also has data divided by gender, age, location and type of procedure performed at the beneficiaries’ hospital, also allows assessing which main groups suffer hospitalizations and illnesses related to preventable causes. According to the survey, the hospitalization rate for people aged 59 and over is 20% – health prevention would prevent more than 4,000 hospitalizations per year.
Unidas is a non-profit associative entity that represents self-management operators in Brazil, with more than one hundred affiliates representing around 4 million beneficiaries throughout the country. Every year, Unidas publishes a study with indicators of the private health sector in the country to base decision-making in the private health sector and by the ANS (National Agency for Supplementary Health).
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