Estimated hospitalizations attributable to diabetes mellitus within the public healthcare system in Brazil from 2008 to 2010: study DIAPS 79.

Abstract

To estimate the number of hospitalizations attributable to diabetes mellitus (DM) and its complications within the public healthcare system in Brazil (SUS) and the mean cost paid per hospitalization. The official database from the Hospital Information System of the Unified Health System (SIH/SUS) was consulted from 2008 to 2010. The proportion of hospitalizations attributable to DM was estimated using attributable risk methodology. The mean cost per hospitalization corresponds to direct medical costs in nursing and intensive care, from the perspective of the SUS. The proportion of hospitalizations attributable to DM accounted for 8.1% to 12.2% of total admissions in the period, varying according to use of maximum (self-reported with correction factor) or minimal (self-reported) DM prevalence. The hospitalization rate was 47 to 70.8 per 10.000 inhabitants per year. The mean cost per hospitalization varied from 1.302 Brazilian Reais (BRL) to 1,315 BRL. Assuming the maximum prevalence, hospitalizations were distributed as 10.3% as DM itself, 36.6% as chronic DM-associated complications and 53.1% as general medical conditions. Advancing age was accompanied by an increase in hospitalization rates and corresponding costs, and more pronounced in male patients. The results express the importance of DM in terms of the use of health care resources and demonstrate that studies of hospitalizations with DM as a primary diagnosis are not sufficient to assess the magnitude of the impact of this disease.