Economic impact of hospitalizations for migraine and other cephalic pain syndromes to the Brazilian Unified Health System

Background: Headache disorders are the third most frequent complaint in ambulatory care facilities, leading to an important loss of healthy years of life. Thus, it is important to study the factors related to hospitalizations due to these syndromes in Brazil. Objective: To describe the profile of hospitalizations due to migraine and other cephalic pain syndromes. Design and methods: This is an ecological study, based on secondary data with a descriptive approach. Data were collected from DATASUS regarding the number of hospitalizations, days spent in hospital, average cost per hospital stay, total amount of expenses, besides sex and age of hospitalized pacients due to migraine and other cephalic pain syndromes from 2011-2020. Results:78.058 hospitalizations were registered, with Southeast region’s prevalence (35.7%). The female and the economically active population (15-64 years) stand out in these results (65.8% and 79.9% respectively). The average permanence was of 3.84 days in SUS and the average value per hospital stay was R$ 407.77. The total amount spent on hospital services was R$ 28,153,255.86. Conclusion: The present study indicates a female and economically active population prevalence in hospitalizations. And also point out a Southeast region’s predominance in total amount of hospitalizations and second place regarding the costs on hospital services.

Self-management program in treatment of asthma

Introduction. Recently published national and international guidelines stress the importance of self-management in asthma. They have recommended that self-management plans should be an essential part of the long-term management of asthmatic patients. These plans essentially focus on the early recognition of unstable or deteoriorating asthma, by monitoring peak flow or symptoms. Objective. The aim of our one-year study was to compare the efficacy of peak-flow based self-management of asthma with traditional treatment. Method. Sixty clinically stable adult patients with mild and moderate persistent asthma were randomly allocated to peakflow based self-management (Group A, n=30) or to conventional treatment (Group B, n=30), with no significant difference between groups in terms of age, sex distribution and initial lung function. The recorded measurements were: lung function, asthma exacerbations, unscheduled ambulatory care facilities (hospital-based emergency department, consultations with general practitioner or pulmonologist), courses of oral prednisolone, courses of antibiotics, days off work. Results. There was a significant difference between groups in number of asthma exacerbations (p<0.05), unscheduled visits to ambulatory care facilities (p<0.005), days off work (p<0.0001), courses of oral prednisolone (p<0.001) and antibiotics (p<0.05). At the final visit, there was a significant improvement in some measurements of asthma severity in group A (reduced unscheduled visits for ambulatory care, reduced treatment requirements for oral corticosteroids and antibiotics, reduced days off work), but a lack of statistical difference in lung function and the maintenance-inhaled corticosteroid dose. There was no significant change in group B. Conclusion. These results suggest that peak-flow based self management is more effective than traditonal treatment in mild and moderate persistent asthma. .