Social determinants of health and heart failure hospitalizations in Brazil

Abstract

Objective: To analyze the relationship between social determinants of health and heart failure hospitalizations in Brazil. Method: A retrospective ecological study, whose units of analysis were the cities of the Brazilian states. The outcome variable was heart failure hospitalization rate. The independent variables were Family Health Strategy coverager, federal transfer to Primary Care, expenditure on Primary Care, overlapping of the female population and age group above 60 years old. Regressive techniques were adopted for panel data, with estimation of weighted least squares by fixed effect. Results: Twenty-six cities were analyzed. Hospitalization rates showed a non-uniform distribution between the areas, with lower median in the North and higher in the South. The regression model identified a relationship between hospitalization rates and Family Health Strategy coverage, federal transfer to Primary Care, and overlapping of the female population. Conclusion: Heart failure occurrence, a condition sensitive to Primary Care in Brazil, is influenced by social determinants of health represented by demographic, budgetary, and health service coverage factors.