Regional Inequalities in Access to Specialized Healthcare in the Brazilian Unified Health System

Author(s)

Braga A1, Huerta C1, Terra M1, Cardoso L2, Santos M1, Zimmermann IR3
1Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil, 2Universidade Federal de Goiás, Goiânia, Brazil, 3Universidade Federal de Brasilia, Brasília, Brazil

Cardiovascular disease (CVD) is the leading cause of death in Brazil, with regional inequalities in both decline in CVD mortality and self-reported diagnoses. Access to healthcare plays a vital role in heart disease screening and treatment. The most used imaging technique for assessing heart structure and functioning is the echocardiography.

OBJECTIVES: Analyse the distribution of outpatient transthoracic echocardiograms carried out in the Unified Health System (SUS) in Brazil in 2019.

METHODS: We used data from echocardiography exam registered in public Outpatient Health Information System (SIA-SUS) as proxy to assess the availability of specialized healthcare in Brazilian Unified health System. In a cross-sectional analysis, we adjusted the total number of registered echocardiograms by population of all states in Brazil. The age-standardized rate was calculate using the direct method.

RESULTS: In 2019, Brazil recorded a total of 1,533,851 echocardiography exams, predominantly in the Southeast (58%), followed by the Northeast (21%), South (13%), Midwest (5%), and North (3%) regions. The average number of exams per 1,000 inhabitants was 7.3 in the country.

São Paulo and Distrito Federal had the highest number of exams, with 14.05 and 7.54 per 1,000 inhabitants, respectively. Conversely, Most states in the North and Northeast recorded fewer than 3.88 exams per 1,000 inhabitants. Amazonas and Roraima had the lowest number of exams, with 1.34 and 2.39 per 1,000 inhabitants each.

Inequalities were similarly observed in the age-standardized rate per 1,000 inhabitants, with higher rates in São Paulo (13.3) and Distrito Federal (8.38), and lower rates in Roraima (2.76) and Amazonas (1.69).

CONCLUSIONS: These findings indicate regional inequalities in performing echocardiogram exams, with the Southeast region, characterized by higher human development index (HDI), conducting a greater number of exams. On the other hand, regions with lower HDI, such as the North and Northeast, had fewer exam entries.

Conference/Value in Health Info

2023-11, ISPOR Europe 2023, Copenhagen, Denmark

Value in Health, Volume 26, Issue 11, S2 (December 2023)

Code

HPR44

Topic

Health Policy & Regulatory, Medical Technologies

Topic Subcategory

Diagnostics & Imaging, Health Disparities & Equity

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas

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