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Título

COSTS AND CASE FATALITY RATES OF THE HOSPITAL TREATMENT OF EPILEPSY IN THE STATE OF BAHIA, BRAZIL

Resumo

Introduction: Epilepsy is one of the most common neurological disorders, characterized by a predisposition to the occurrence of unprovoked seizures. Worldwide, there are about 50 million people living with epilepsy and 125,000 deaths related to the disease per year, of which 80% occur in low- and middle-income countries. Due to its high prevalence and chronicity, epilepsy results in high costs for healthcare systems and patients. Thus, we aimed to evaluate the frequency of hospitalizations, costs and deaths related to the public hospital care of epilepsy in the state of Bahia, Brazil. Methods: Ecological study, carried out with data from SIH/SUS, extracted from the DATASUS platform. The period from January 2017 to December 2021 was considered. The ICD G40 was the selection parameter used. Data was collected on the number of hospitalizations, total cost, mean cost per hospitalization, mean length of hospital stay (LOS), deaths, and case fatality rate (CFR) according to the variables gender, race and age group. Results: In the 5 year period, there were 16472 hospitalizations for epilepsy in Bahia. The total sum spent was R$ 12,833,908.38, and the mean cost per hospitalization was R$ 766.57. The mean LOS was 6.3 days and there were 650 deaths, with a CFR of 3.9%. Males were hospitalized more frequently than females (59.5% vs. 40.5%), with similar costs (R$ 802.75 vs. 713.40). Patients of mixed race were the majority (54.9%), followed by whites (3.5%) and blacks (3.4%). Compared to other race groups, the mean cost for black patients was the highest (R$ 2392.33), as were the mean LOS (25.1 days) and the CFR (4.49%). Patients aged 1 to 4 years were the most frequently hospitalized, corresponding to 19.9% ​​of the total. The age group between 0 and 1 year had the highest mean cost (R$ 1216.54). The highest CFRs were observed in patients aged 70 to 79 years (8.3%) and in patients that were 80 years old or more (13.4%). Conclusions: Black patients' hospitalizations resulted in higher mean cost, longer LOS, and higher CFR, which may be related to inadequate access to primary health care to treat the underlying disease, but also to low income and deficient social support to maintain post-discharge care amongst this population. Infancy epileptic syndromes are more difficult to control, resulting in more frequent hospitalizations and higher costs. Elderly patients have more comorbidities, as well as an inherent physiological fragility, which implies greater fatality.

Palavras Chave

hospitalization, epilepsy, costs, case fatality rate

Área

Epilepsia