Internação de pacientes por doença hepática no Brasil de 2009 a 2018

Abstract

Liver diseases are a major cause of hospitalization worldwide, and has been on the rise over the last few decades, mainly due to chronic liver diseases such as alcohol, non-alcoholic fat, cirrhosis and chronic hepatitis by the C virus, which, without the appropriate assistance, increase the hospital costs of assistance for these patients, creating the possibility of an unfavorable evolution of these, who may need a liver transplant. Objective: to define the average hospitalization time for liver disease patients by region of Brazil, from 2009 to 2018, correlating with the expenses related to this permanence and their respective mortality rate. Method: ecological, quantitative and descriptive methodology, based on data, publicly available through SIH/ DATASUS. Results: there was a downward trend in the number of hospitalizations for liver diseases in 2018. Even though it is not statistically significant, the reduction is mainly due to alcoholic liver diseases. It was also noted that other liver diseases lead the number of hospitalizations in Brazil, mainly affecting males in the 40-59 age group, with a downward trend of 20-39 years. Regarding the average stay, in Brazil, the average is 8.5 days for alcoholic diseases and 8.8 days for non-alcoholic ones, with less stay in the South region (7.4 days) and more days in the North and Northeast (9.3 days). With regard to the amount paid for the treatment of liver diseases, there was a 58,4% increase in the 10 years studied. The highest hospital mortality rate is mainly due to alcoholic disease, with the southeast region having the highest mortality rate; and to the north, the smallest. In addition, mortality from general liver disease in Brazil, by region, was caused mainly by alcoholic disease, in the 40-59 age group, and liver fibrosis and cirrhosis for those over 60, predominantly in men. Regarding liver transplants, the number of cases has been growing slowly over the period studied, with the largest increase in expenses observed in the period from 2011 to 2014 due to the implementation of new transplant centers, in which the southeast region was the one that had the largest number of these procedures. Conclusion: It was noted that the amount paid for hospital services for the treatment of liver disease patients increased by 58,4% in the decade studied, but the average hospital stay remained practically constant, as well as the hospital mortality rate by region, per year, did not have a significant change, showing that even when spending more, the service is unable to maintain its efficiency and effectiveness.