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首页> 外文期刊>Sao Paulo Medical Journal >Determinants of outpatient expenditure within primary care in the Brazilian National Health System
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Determinants of outpatient expenditure within primary care in the Brazilian National Health System

机译：巴西国家卫生系统中初级保健中门诊​​费用的决定因素

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CONTEXT AND OBJECTIVE: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru. DESIGN AND SETTING: Cross-sectional study conducted in five primary care units in Bauru (SP), Brazil. METHODS: Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews. RESULTS: The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests). Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01), hypertension (OR = 3.04; 95% CI: 1.91-4.82) and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81). Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47) and female sex (OR = 1.70; 95% CI: 1.14-2.55). CONCLUSIONS: Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.
机译：背景与目的：全球政府面临的最大挑战之一是医疗保健系统的融资。因此，有必要了解与医疗保健支出相关的因素和关键组成部分。这里的目的是确定通过Bauru市的巴西国家卫生系统就诊的成年人中，与初级保健中直接医疗保健支出相关的人口统计，社会经济，生活方式和临床因素。设计与地点：在巴西Bauru（SP）的五个初级保健单位中进行的横断面研究。方法：通过对年龄在50岁以上的成年人的医疗记录进行评估，以评估过去12个月的医疗保健支出。年度医疗保健支出根据药物，实验室检查，医疗咨询和总费用进行评估。通过面对面访谈评估了体重指数，腰围，高血压，年龄，性别，体育活动和吸烟。结果：本次调查的963名参与者的总医疗保健支出为112,849.74美元（咨询费率为46.9％，药物治疗费率为35.2％，实验室测试费率为17.9％）。药物支出与超重（比值比，OR = 1.80; 95％置信区间，CI：1.07-3.01），高血压（OR = 3.04; 95％CI：1.91-4.82）和中等程度的体育锻炼（OR = 0.56; 95％CI：0.38-0.81）。咨询费用与高血压（OR = 1.67; 95％CI：1.12-2.47）和女性（OR = 1.70; 95％CI：1.14-2.55）有关。结论：我们的结果表明，超重，较低的体力活动水平和高血压是与初级保健中较高的医疗保健支出相关的独立危险因素。

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