Health Promotion Programs Can Mitigate Public Spending on Hospitalizations for Stroke: An Econometric Analysis of the Health Gym Program in the State of Pernambuco, Brazil

Abstract

Health promotion programs can reduce morbidity and mortality from chronic diseases, as well as public spending on health. The current study aims to evaluate the effects of the Health Gym Program on expenditures on hospitalizations for stroke in the state of Pernambuco, Brazil. This public policy impact assessment used an econometric model that combines the difference-in-difference estimator with propensity score matching. Data referring to the health, demographic, and socioeconomic characteristics of the 185 municipalities in Pernambuco were collected for the period from 2007 to 2019. Validation tests were carried out of the empirical strategy, the estimation of models with fixed effects for multiple periods and validation post-tests, and robustness of the results. In total, US$ 52,141,798.71 was spent on hospitalizations for stroke, corresponding to 4.42% of the expenses on hospitalizations for all causes over the period studied. Municipalities that implemented the Health Gym Program spent 17.85% less on hospitalizations for stroke than municipalities that did not. The findings of this study indicate that the Health Gym Program was effective in reducing expenses with hospitalizations for stroke and that its implementation has the potential to reduce expenses related to rehabilitation, sick leave, and early retirement.