Evolution of Mortality and Expenditure in the Brazilian Unified Health System (SUS) in the Hospitalar Treatment of Chronic Kidney Disease between 2015 and 2024

 

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https://storage.unitedwebnetwork.com/files/1099/3cc894c95949b9ac73b6cb4d374fd51c.pdf
Evolution of Mortality and Expenditure in the Brazilian Unified Health System (SUS) in the Hospitalar Treatment of Chronic Kidney Disease between 2015 and 2024

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Geraldo
Bezerra da Silva Júnior
André Libório daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Janilson Félix daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Camilla Graça daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
João Davi de Assis daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Maria Sofia Bezerra daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Ryan Coutinho daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Ângelo Roncalli Filho daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Isabella Neri daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Rodrigo Costa Maia daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Maria Giulia Maranhão daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
João Vitor Feitosa daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Davi Pierre daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Dina Magalhães daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Rafael Odon daavipierre@gamil.com University of Fortaleza Medicine Fortaleza Brazil -
Geraldo Bezerra da Silva Júnior geraldobsilvajr@yahoo.com University of Fortaleza Medicine Fortaleza Brazil *

Chronic Kidney Disease (CKD) is a major global public health issue, strongly associated with increased morbidity, mortality, and healthcare costs. In Brazil, CKD progression is closely linked to the rising prevalence of hypertension, diabetes mellitus, and population aging, contributing to greater demand for hospitalizations and renal replacement therapies.  

Analyzing CKD-related mortality and healthcare costs within Brazil's Unified Health System (SUS) is essential for guiding public health strategies, allocating resources, and improving patient care.

This is a retrospective quantitative study analyzing data from the Brazilian Public Health System's Hospital Information System (SIH/SUS) between 2015 and 2024. Absolute numbers of hospital admissions, deaths, mortality rates, total and average expenditures related to the hospital treatment of CKD in Brazil were evaluated. Data were obtained through the DATASUS platform, with temporal and regional analysis of indicator variations. Descriptive statistics were used to assess absolute numbers, rates, and costs, along with statistical tests to identify significant regional differences.

From 2015 to 2024 there were 602,602 hospital admissions for CKD and 75,877 deaths, resulting in a mortality rate of 12%. Southeast had the highest number of admissions and deaths (257,353 and 33,382, respectively), but Northeast had the highest mortality (13,8%). Admissions increased in all regions resulting in an increase of almost 30% by the end of the period. The same was found for deaths, increasing 13% in absolute number, but mortality rate decreased from 13,25% in 2015 into 11,62% in 2024, only the south region had an increase of mortality, turning 10,76% into 10,91% in the period. The peak in admissions and deaths was in 2023, but the peak in mortality rate was in 2021. The total expenditure was U$255,484,329.70 and increased 102%. All regions had similar evolution in the total expenditure. Average cost per patient was US$423.90 and increased 56% in the period. The South-east had the highest expenditure in the period (US$112,315,609). The peak in total expenditure and in the average cost was in 2023. All regions showed significant differences in all these data.

Between 2015 and 2024, CKD posed a major challenge for SUS in terms of mortality and hospital costs. While admissions and deaths increased in absolute numbers, mortality rates gradually declined, indicating improvements in care. Regional disparities remain, with higher mortality in the Northeast and a slight increase in the South. Economically, the sharp rise in total and average costs underscores the pressure of CKD on SUS resources, intensified by population aging and the prevalence of hypertension and diabetes. These findings highlight the need for public health policies focused on prevention, early diagnosis, and outpatient care, to reduce hospitalizations, avoid complications, and optimize resources.

Kewords