Efeitos da estrutura etária nos gastos com internação no Sistema Único de Saúde: Uma análise de decomposição para duas áreas metropolitanas brasileiras

Abstract

This paper examines the impact of changes in population age distribution on inpatient care expenditures in Brazil. The authors use data from two highly distinct metropolitan areas, Curitiba (Paraná State) and Belém (Paraná State), in order to determine to what extent current differences in expenditures are explained by differences in: (i) age distributions, (ii) age-specific expenditures (price effects), and (iii) utilization rates (rate effects). The study also looks at the consequences of future changes in age distribution by simulating each of the effects (age distribution, price, and rate) under the projected population age distribution for Brazil in 2050. The results show that only 13% of current differences in health expenditures in Curitiba and Belém are explained by differences in age distribution. Most of the difference is due to price effect (72%), probably because of large socioeconomic and epidemiological discrepancies in these two metropolitan areas. However, simulations for 2050 suggest that most future changes in inpatient care will be explained by population aging effects.