Prevalence and economic impact of acute myocardial infarction in the brazilian public health system: care and economic analysis and the impacts of the Coronavirus disease

Abstract

Introduction: This study aimed to describe the general and specific context of hospitalizations for acute myocardial infarction (AMI) in the Brazilian public health system and its main indicators of cost-effective care in the period before and during the coronavirus (COVID-19) pandemic. Method: The main assistance and economic indicators of care related to AMI were evaluated, along with the Brazilian public health system, from January 2011 to April 2021, comparing the pre-covid indicators and those during the pandemic. The research data were descriptive and exploratory, using data from the Ministry of Health. The main data evaluated were lethality, number of hospitalizations, average length of stay and hospitalization costs. The ARIMA and general regression models were used to analyze the monthly outcomes pre and during COVID-19, thus enabling changes in the care and economic behavior of AMI cases in the public health system. Results: Hospitalization for AMI has increased over the last 10 years, with a slight decrease during COVID-19. There was an equally slight increase in lethality, with a significant decrease in the mean length of stay of hospitalized patients. The economic aspects of IAM show that more than US$ 762 million were invested during the reporting period. The average ticket presents a clear decrease in investment per capita, with a real devaluation of 70.04% in the period from 2011 to April 2021, which may be related to two main hypotheses: (1) increased effectiveness and (2) cost analysis of the effectiveness of care and/or chronic underfunding of the Brazilian public health system. Conclusion: There was a historical increase in hospitalizations and a reduction in IAM-related deaths.