Lucimara Garcia Baena Moura

Abstract

Introduction: Demographic and epidemiological changes have caused disparities in morbidity and mortality patterns and life expectancy. Therefore, there was an increase in the elderly population and a greater concern with preserving the quality of life of this population. Objective: To evaluate the spatial distribution and the impact of influenza vaccine coverage regarding costs and morbidity and mortality due to respiratory diseases of the elderly in Brazil. Method: This is a quantitative, cross-sectional, descriptive, and analytical study. We analyzed all hospital admissions between 2010 to 2019 due to respiratory diseases in the SIH-SUS from the DataSus Tabnet, as well as the information regarding vaccination coverage retrieved from SIPNI in the same period. All analyzes were performed in the R statistical environment. Results: Between 2010-2019 there were 3,890,740 hospitalizations of the elderly, and among these, more than 35% were patients aged 80 years or over, 50.38% were male, 42.44% of color/race white and the most common ICD-10 classification was pneumonia (61.50%). Concerning the average cost of hospitalizations, per inhabitant, the amount of R$31.60 was observed, considering Brazil as a whole, and for the states of Paraná and Santa Catarina, this value exceeded R$ 50.00, while states such as Amapá, Bahia, Maranhão, among others, the cost did not reach R$ 20.00. In the Federal District and Goiás, the average vaccination coverage was 100% in the evaluated period. In contrast, the lowest coverage (85%) was found in Bahia. The average mortality rate in the period was 17.30% for Brazil, exceeding 30% in the state of Rio de Janeiro and Sergipe, and not reaching 10% in Maranhão. The correlation of the different variables under study showed a negative correlation between vaccine costs and vaccine coverage with hospitalization costs. Further, concerning mortality, the average mortality rate and vaccination coverage showed a positive correlation. It is observed that the 3,890,740 hospitalizations of elderly people due to respiratory diseases reported between January 2010 and December 2019 are distributed between the years so that the cases of 2010, the first year under study, represent 9.41% of the total, while in 2019 10.76% of hospitalizations were observed, showing a gradual increase in the number of cases over the year. On the other hand, although the number of hospitalizations has increased, the cost of hospitalizations per inhabitant decreased from R$ 35.04 to R$ 28.25 from the beginning to the end of the period. Conclusion: Elderly >80 years is the age group with the highest representativeness in hospitalizations; with a slightly higher number of men, white color/race, and the main cause of hospitalization was pneumonia. It was found that the higher the cost of vaccines and the greater the vaccine coverage, the lower the cost of hospitalizations was. Concerning mortality, the higher the vaccine coverage, the higher the mortality rate tends to be. There are regional differences, whether between states and macro-regions that need more focus on analysis to get to know the reality of each area