Hospitalizations for diabetes mellitus in older people in Brazil from 2001 to 2020: temporal trends and spatial patterns

Abstract

Objective

To analyze temporal and spatial patterns in the distribution of hospitalization rates for diabetes mellitus in older people (60 years or older) in Brazil.

Method

Ecological study with data from the Hospitalization Information System of the Unified Health System about hospitalizations for diabetes in older people in Brazil from 2001 to 2020. The hospitalization rate/100,000 older people was calculated, and the temporal trend was analyzed using the Joinpoint Regression. Univariate and bivariate MoranMap maps were constructed, and the Skater technique was applied to analyze the association between hospitalization rates and contextual variables by Immediate Urban Articulation Regions.

Results

Annual rates show that Brazil registered 43.78 hospitalizations for diabetes/100,000 older people in 2001 and 21.55/100,000 older people in 2020, with a significant downward trend (AAPC=-3,4% IC95% -4,5; -2,3). There was an average spatial autocorrelation by global Moran (I<0,3) in the last five years with regions with high rates of hospitalization in the North and Northeast of Brazil. The bivariate analysis showed the formation of clusters with high rates of hospitalization where there was a high coverage of the Family Health Strategy and a supply of professionals, however, in areas with worse social indicators. The Skater map showed clusters of areas with low hospitalization rates in areas of favorable social conditions in Southeast Brazil.

Conclusion

The expansion of government policies to protect the health of older people has marked a national commitment to the healthy aging of the population, which is reflected in the decline in hospitalization rates for diabetes among older people in Brazil.

Keywords
Hospitalization; Elderly; Diabetes Mellitus; Trend; Spatial Analysis