Psychiatric hospitalizations in Brazil: exploratory and trend analysis from 2009 to 2019

Marina Goulart Da Silva,Betine Pinto Moehlecke Iser,Rafael Mariano De Bitencourt,Guilherme Cabreira Daros

doi:10.1590/0047-2085000000303

Marina Goulart Da Silva, Betine Pinto Moehlecke Iser + Show 2 more

Open Access

https://doi.org/10.1590/0047-2085000000303

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Abstract

ABSTRACT Objective: To examine the rates of psychiatric hospitalization and the average length of stay, in Brazil, from 2009 to 2019, according to sociodemographic variables and character of the hospitalization (elective or urgency). Methods: This is an ecological study, with data collected from the Hospital Information System of the Unified Health System (SIH/SUS). Hospital admission rates were described according to diagnosis, sex, and age group. Percentage variation and rate ratios were calculated. To evaluate the time series, the data were submitted to linear regression analysis. Results: The rate of hospitalization for mental disorders decreased from 14.2/10,000 in 2009 to 11.2 in 2019, with the most significant variation occurring between mental and behavioral disorders due to alcohol use. The men had about twice as many episodes as the women in all the years evaluated. Higher rates were found in the age group of 30 and 59 years. The length of stay also decreased in the period. Besides, the urgency character presented almost 82% of the total hospitalizations. Conclusions: There was a reduction in hospital admissions for mental disorders in the analyzed period, demonstrating the relevance of mental health care changes resulting from the Psychiatric Reform.

Highlights

The need for mental health care changes began to be debated in Europe in the 1960s, but it was only in the 1980s that psychiatric reform began to be constituted in Brazil[1]
This reform aimed to reintegrate the individual affected by mental disorders, the restructuring of all mental health services, the focus on primary care – especially with the emergence of Psychosocial Care Centers (CAPS) – and the creation of new substitute devices for psychiatric hospitalization[2,3]
The data analyzed in the present study demonstrate a trend to decrease hospitalizations for mental and behavioral disorders between 2009 and 2019

Summary

Introduction

The need for mental health care changes began to be debated in Europe in the 1960s, but it was only in the 1980s that psychiatric reform began to be constituted in Brazil[1]. This reform aimed to reintegrate the individual affected by mental disorders, the restructuring of all mental health services, the focus on primary care – especially with the emergence of Psychosocial Care Centers (CAPS) – and the creation of new substitute devices for psychiatric hospitalization[2,3]. The Return Home Program, in turn, is one of the main instruments in the psychosocial rehabilitation process, contributing to the social insertion process of people with a long history of hospitalization in these hospitals, through the monthly payment of rehabilitation assistance and a network mental health care capable of meeting the individual’s demands[4]

Results

Discussion

Conclusion