HOSPITAL ADMISSIONS FOR DIABETES MELLITUS IN SERGIPE, NORTHEASTERN BRAZIL, FROM 2008 TO 2017: AN ECOLOGICAL STUDY

Abstract

Diabetes mellitus is a primary care-sensitive condition characterized by persistently elevated blood glucose levels. The worldwide prevalence is 8.8% and in Brazil, 7.6%. Objective: To describe the evolution of hospitalization rates, length of hospital stay, and expenditures on diabetes mellitus, in the State of Sergipe, Brazil, from 2008 to 2017. Method: A descriptive time series study was carried out in which data were obtained from Hospital Admission Authorizations registered in the Hospital Information System of the Unified Health System. The data were read and analyzed by the statistical program R. Results: Sergipe recorded 608,083 hospitalizations by the Unified Health System in this period, of which 125,497 were hospitalizations for conditions sensitive to Primary Care (20.6%). Diabetes mellitus was responsible for 7.2% of these hospitalizations, being the sixth most frequent cause (the third among individuals over 50 years of age). The overall rate in the period was 4.1/10,000 inhabitants. (3.8 in men and 4.4 in women). The variation was irregular, with a resulting increase in the hospitalization rate. Length of hospital stay increased by 0.12 days per year during the period (95% CI 0.06 to 0.19). The cost of hospitalization increased with length of stay, with an average of $24.4 (95% CI 23.14 to 25.58) per day of hospitalization. Conclusion: Primary Care has a preponderant role in the prevention, early diagnosis and treatment of diabetes mellitus to avoid premature hospital admissions. The research showed an irregular behavior in the hospitalization curve in the period, which gives rise to new research for causal determinants. The risk of hospitalization was higher in females, but in the last years of life it was unusually higher in men. The decrease in spending is worrying, especially with the poorest part of the population, since the disease continues to rise and predominates in this group.