Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.

<h4>Introduction</h4>Systemic arterial hypertension (SAH), a global public health problem and the primary risk factor for cardiovascular diseases, has a significant financial impact on health systems. In Brazil, the prevalence of SAH is 23.7%, which caused 203,000 deaths and 3.9 million...

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Autores principales:	Daniel da Silva Pereira Curado, Dalila Fernandes Gomes, Thales Brendon Castano Silva, Paulo Henrique Ribeiro Fernandes Almeida, Noemia Urruth Leão Tavares, Camila Alves Areda, Everton Nunes da Silva
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/51bbc62006414968ac0757459da4dbb6
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spelling	oai:doaj.org-article:51bbc62006414968ac0757459da4dbb62021-12-02T20:10:46ZDirect cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.1932-620310.1371/journal.pone.0253063https://doaj.org/article/51bbc62006414968ac0757459da4dbb62021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253063https://doaj.org/toc/1932-6203<h4>Introduction</h4>Systemic arterial hypertension (SAH), a global public health problem and the primary risk factor for cardiovascular diseases, has a significant financial impact on health systems. In Brazil, the prevalence of SAH is 23.7%, which caused 203,000 deaths and 3.9 million DALYs in 2015.<h4>Objective</h4>To estimate the cost of SAH and circulatory system diseases attributable to SAH from the perspective of the Brazilian public health system in 2019.<h4>Methods</h4>A prevalence-based cost-of-illness was conducted using a top-down approach. The population attributable risk (PAR) was used to estimate the proportion of circulatory system diseases attributable to SAH. The direct medical costs were obtained from official Ministry of Health of Brazil records and literature parameters, including the three levels of care (primary, secondary, and tertiary). Deterministic univariate analyses were also conducted.<h4>Results</h4>The total cost of SAH and the proportion of circulatory system diseases attributable to SAH was Int$ 581,135,374.73, varying between Int$ 501,553,022.21 and Int$ 776,183,338.06. In terms only of SAH costs at all healthcare levels (Int$ 493,776,445.89), 97.3% were incurred in primary care, especially for antihypertensive drugs provided free of charge by the Brazilian public health system (Int$ 363,888,540.14). Stroke accounted for the highest cost attributable to SAH and the third highest PAR, representing 47% of the total cost of circulatory diseases attributable to SAH. Prevalence was the parameter that most affected sensitivity analyses, accounting for 36% of all the cost variation.<h4>Conclusion</h4>Our results show that the main Brazilian strategy to combat SAH was implemented in primary care, namely access to free antihypertensive drugs and multiprofessional teams, acting jointly to promote care and prevent and control SAH.Daniel da Silva Pereira CuradoDalila Fernandes GomesThales Brendon Castano SilvaPaulo Henrique Ribeiro Fernandes AlmeidaNoemia Urruth Leão TavaresCamila Alves AredaEverton Nunes da SilvaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0253063 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Daniel da Silva Pereira Curado Dalila Fernandes Gomes Thales Brendon Castano Silva Paulo Henrique Ribeiro Fernandes Almeida Noemia Urruth Leão Tavares Camila Alves Areda Everton Nunes da Silva Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.
description	<h4>Introduction</h4>Systemic arterial hypertension (SAH), a global public health problem and the primary risk factor for cardiovascular diseases, has a significant financial impact on health systems. In Brazil, the prevalence of SAH is 23.7%, which caused 203,000 deaths and 3.9 million DALYs in 2015.<h4>Objective</h4>To estimate the cost of SAH and circulatory system diseases attributable to SAH from the perspective of the Brazilian public health system in 2019.<h4>Methods</h4>A prevalence-based cost-of-illness was conducted using a top-down approach. The population attributable risk (PAR) was used to estimate the proportion of circulatory system diseases attributable to SAH. The direct medical costs were obtained from official Ministry of Health of Brazil records and literature parameters, including the three levels of care (primary, secondary, and tertiary). Deterministic univariate analyses were also conducted.<h4>Results</h4>The total cost of SAH and the proportion of circulatory system diseases attributable to SAH was Int$ 581,135,374.73, varying between Int$ 501,553,022.21 and Int$ 776,183,338.06. In terms only of SAH costs at all healthcare levels (Int$ 493,776,445.89), 97.3% were incurred in primary care, especially for antihypertensive drugs provided free of charge by the Brazilian public health system (Int$ 363,888,540.14). Stroke accounted for the highest cost attributable to SAH and the third highest PAR, representing 47% of the total cost of circulatory diseases attributable to SAH. Prevalence was the parameter that most affected sensitivity analyses, accounting for 36% of all the cost variation.<h4>Conclusion</h4>Our results show that the main Brazilian strategy to combat SAH was implemented in primary care, namely access to free antihypertensive drugs and multiprofessional teams, acting jointly to promote care and prevent and control SAH.
format	article
author	Daniel da Silva Pereira Curado Dalila Fernandes Gomes Thales Brendon Castano Silva Paulo Henrique Ribeiro Fernandes Almeida Noemia Urruth Leão Tavares Camila Alves Areda Everton Nunes da Silva
author_facet	Daniel da Silva Pereira Curado Dalila Fernandes Gomes Thales Brendon Castano Silva Paulo Henrique Ribeiro Fernandes Almeida Noemia Urruth Leão Tavares Camila Alves Areda Everton Nunes da Silva
author_sort	Daniel da Silva Pereira Curado
title	Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.
title_short	Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.
title_full	Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.
title_fullStr	Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.
title_full_unstemmed	Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.
title_sort	direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the brazilian public health system in 2019.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/51bbc62006414968ac0757459da4dbb6
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Direct cost of systemic arterial hypertension and its complications in the circulatory system from the perspective of the Brazilian public health system in 2019.

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