Abstract
One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. Cross-sectional study conducted in five primary care units in Bauru (SP), Brazil. Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests). Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01), hypertension (OR = 3.04; 95% CI: 1.91-4.82) and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81). Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47) and female sex (OR = 1.70; 95% CI: 1.14-2.55). Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.
Highlights
One of the big challenges facing governments worldwide is the financing of healthcare systems
The prevalence of hypertension was 76.8%, while diabetes mellitus and dyslipidemia were observed in 28.5% and 32.4% of the sample, respectively
The total annual healthcare expenditure for the 963 participants of this survey was US$ 112,849.74 and the maximum amount spent on any patient was U$ 941.78 per year
Summary
One of the big challenges facing governments worldwide is the financing of healthcare systems. The challenge is more difficult in developing nations, due to limited budgets, and because of the increasing prevalence of chronic diseases.[1,2,3] In 2005, cardiovascular diseases and diabetes mellitus were the leading causes of mortality in developing nations, accounting for 30% of deaths.[1] in 2012, among the 56 million deaths that occurred, 67.8% were due to chronic diseases, especially cardiovascular and respiratory diseases and cancer.[4]. In 2011, the costs relating to maintenance of the Brazilian National Health System accounted for 9% of the national GDP.[5]
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