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| Author(s): |
Lionai Lima dos Santos
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Presidente Prudente. 2021-03-25. |
| Institution: | Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente |
| Defense date: | 2021-03-08 |
| Advisor: | Jamile Sanches Codogno |
| Abstract | |
Arterial hypertension is a global health problem that affects more than one billion people worldwide, and is responsible for more than nine million deaths per year, however, it is still necessary to expand research on the impact of arterial hypertension in costs of primary and secondary care, as well as the relationship between physical activity and these costs. Thus, the objective of this study is to estimate the impact of isolated arterial hypertension and associated with other morbidities on the costs of health services in primary and secondary care in SUS, as well as to identify the role of physical activity in this relationship. The costs of health services were verified through medical records, provided by the Health Department of Presidente Prudente and by the Regional Hospital of the city. The level of habitual physical activity was assessed by means of a questionnaire, for statistical purposes the score was divided into quartiles, from which individuals classified in the highest quartile p≥75 and below were considered active, considered as IA (insufficiently active). Statistical analyzes were expressed as mean, standard deviation, median and interquartile range. The General Linear Model (GLM), and marginal effect analysis was used, which interprets the log data generated by GLM and estimates it in monetary data. The analyzes were performed using the software Stata / MP4 16 - Student - Perpetual, the p-value was established at less than 5%. The results of this research were organized into two scientific articles. In the first study, the sample consisted of 306 patients, aged 30 to 65 years, of which 66.4% of the population were hypertensive. It was possible to observe that the HA IA group had higher estimates than the Normotensive ACTIVE group in the values of the cost variables (care services US $ 20.00 (CI = 9.90; 30.2), medicines US $ 34.20 ( CI = 18.9; 49.5) and total primary care US $ 51.60 (CI = 30.2; 72.9)), unlike HA ACTIVE, which showed a significant difference only in care services (US $ 13 , 40 (CI = 1.34; 25.4), with no difference in secondary and tertiary care. In the second article, the sample consisted of 280 patients, also aged between 30 and 65 years. It is possible to observe that all groups of morbidities had higher estimates of health costs than the reference group (group without diagnosis of hypertension, diabetes, cholesterol and hearth attack) in the years 2018 and 2019 in primary care, and the physically active group presented a cost reduction of US $ 20.40 (CI = -39.3; -1.52) compared to the less active group, however in secondary and tertiary care only the groups with AHU $ 426.7 (CI = 61.0 ; 792.5), and the group that had all morbidities US $ 816.20 (CI = 59.8; 1572.6) and HA + CHO + infarction US $ 614.40 (CI = 51.6; 1177, 1) showed a significant difference. And it was also possible to observe that the most active group had 4.12 (CI = -11.6; 3.41) fewer days in hospital than the IA group. We conclude that HA has a strong impact on health care costs, both in primary, secondary and tertiary care, and the physical activity associated with HA enables savings in health care costs. (AU) | |
| FAPESP's process: | 18/07281-9 - Impact of arterial hypertension on the costs of primary and secondary health care: the role of physical activity |
| Grantee: | Lionái Lima dos Santos |
| Support Opportunities: | Scholarships in Brazil - Master |