Dataset Information

Epidemiology of sepsis in Brazil: Incidence, lethality, costs, and other indicators for Brazilian Unified Health System hospitalizations from 2006 to 2015.

ABSTRACT: Sepsis is considered a major worldwide health burden, with high mortality and associated costs. Health indicators are essential to define strategies to improve the treatment of diseases, and the epidemiology information of sepsis in developing countries is scarce. Thus, the aim of this work is to assess trends in the incidence, lethality, costs, and other indicators of sepsis for Brazilian Unified Health System (SUS-Sistema Único de Saúde) hospitalizations for the period from January 2006 to December 2015.We conducted this study using data from the SUS hospital information system. We selected registries of SUS hospitalizations of patients diagnosed with sepsis (total of 724,458 cases from 4,271 public and private Brazilian hospitals).From 2006 to 2015, the annual sepsis incidence increased 50.5% from 31.5/100,000 to 47.4/100,000 persons. The mean hospital length of stay (LOS) was 9.0 days. A total of 29.1% of the hospitalizations had admission to the intensive care unit (ICU) with a mean ICU LOS of 8.0 days. The mean cost per hospitalization was US$624.0 and for hospitalizations requiring intensive care was U$1,708.1. The overall sepsis lethality rate was 46.3%, and for hospitalizations with admission to the ICU, it was 64.5%. During the study period, the lethality rate for children/teenagers decreased 40.1%, but for all other age groups it increased 11.4%. The sepsis lethality rate in public hospitals (55.5%) was higher than private hospitals (37.0%) (p < 0.001). The mean hospitalization LOS for public hospitals (10.3 days) was higher than private hospitals (7.6 days) (p < 0.001).The incidence and lethality rate of sepsis increased in SUS hospitalizations during the study period. The SUS's low reimbursement to hospitals for treating sepsis may be one of the reasons for the high lethality rate.

SUBMITTER: Quintano Neira RA

PROVIDER: S-EPMC5898754 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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Epidemiology of sepsis in Brazil: Incidence, lethality, costs, and other indicators for Brazilian Unified Health System hospitalizations from 2006 to 2015.

Quintano Neira Ricardo Alfredo RA Hamacher Silvio S Japiassú André Miguel AM

PloS one 20180413 4

<h4>Background</h4>Sepsis is considered a major worldwide health burden, with high mortality and associated costs. Health indicators are essential to define strategies to improve the treatment of diseases, and the epidemiology information of sepsis in developing countries is scarce. Thus, the aim of this work is to assess trends in the incidence, lethality, costs, and other indicators of sepsis for Brazilian Unified Health System (SUS-Sistema Único de Saúde) hospitalizations for the period from ...[more]

PMID: 29652944

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Project description:BackgroundHomicide presents a significant health burden globally, but geographical differences in homicide rates necessitate focussed analyses of spatial and temporal patterns, particularly in affected areas. The highest rates are concentrated in regions in Central and South America, but analyses of sub-regional patterns and sex-specific differences may yield important information for addressing the upstream causes of homicide at the community level.ObjectiveThis study examines and presents spatial and temporal patterns of homicide victims from 2006 to 2015 in the state of Alagoas, Brazil, focussing on the municipality scale and differentiated by victims' sex.MethodsData comprising victims' age, sex, the date, time, and the municipality of the homicide incident were acquired from the Brazilian National Mortality Information System. These data were aggregated by municipality, and we made quantitative comparisons of sex-specific homicide rates between the capital city of Macieó metropolitan region and the peripheral, predominantly rural regions. Empirical Local Bayes methods were used to adjust per-capita homicide risk estimates and map the results.ResultsA total of 19,560 homicides occurred during the study period, with an average of 60.4 per 100,000 inhabitants; the metropolitan region rate was 81.8, compared to 46.5 for the remaining regions. The male homicide rate was 115.9 per 100,000, compared to 7.1 for females. Empirical Local Bayes mapping showed strong clustering of male homicide risk in specific cities near the capital, while female risk was more dispersed throughout the region.ConclusionsThe risk of male victim homicide observed for the metropolitan region of Alagoas was amongst the highest globally, particularly during the period 2012-2014. Geographical differences in male and female risk may indicate differences in risk factors and highlight a need for prevention programmes that take into account gender-specific pathways of violence.

Project description:BackgroundInpatient palliative care is associated with lower inpatient costs; however, this has yet to be studied using a more nuanced, multi-tiered measure of inpatient palliative care and a national population-representative dataset. Using a population-based cohort of Canadians who died in hospital, our objectives were to: describe patients' receipt of palliative care and active interventions in their terminal hospitalization; and examine the relationship between inpatient palliative care and hospitalization costs.MethodsRetrospective cohort study using data from the Discharge Abstract Database in Canada between fiscal years 2012 and 2015. The cohort were Canadian adults (age ≥ 18 years) who died in hospital between April 1st, 2012 and March 31st, 2015 (N = 250,640). The exposure was level of palliative care involvement defined as: medium-high, low, or no palliative care. The main measure was acute care costs calculated using resource intensity weights multiplied by the cost of standard hospital stay, represented in 2014 Canadian dollars (CAD). Descriptive statistics were represented as median (IQR), and n(%). We modelled cost as a function of palliative care using a gamma generalized estimating equation (GEE) model, accounting for clustering by hospital.ResultsThere were 250,640 adults who died in hospital. Mean age was 76 (SD 14), 47% were female. The most common comorbidities were: metastatic cancer (21%), heart failure (21%), and chronic obstructive pulmonary disease (16%). Of the decedents, 95,450 (38%) had no palliative care involvement, 98,849 (38%) received low involvement, and 60,341 (24%) received medium to high involvement. Controlling for age, sex, province and predicted hospital mortality risk at admission, the cost per day of a terminal hospitalization was: $1359 (95% CI 1323: 1397) (no involvement), $1175 (95% CI 1146: 1206) (low involvement), and $744 (95% CI 728: 760) (medium-high involvement).ConclusionsIncreased involvement of palliative care was associated with lower costs. Future research should explore whether this relationship holds for non-terminal hospitalizations, and whether palliative care in other settings impacts inpatient costs.

Dataset Information

Epidemiology of sepsis in Brazil: Incidence, lethality, costs, and other indicators for Brazilian Unified Health System hospitalizations from 2006 to 2015.

Publications

Epidemiology of sepsis in Brazil: Incidence, lethality, costs, and other indicators for Brazilian Unified Health System hospitalizations from 2006 to 2015.

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