To live and die: what is driving up the cost of hospitalization in Brazil?

Claudia Berenstein, Centro de Desenvolvimento e Planejamento Regional (CEDEPLAR)
Roberto Rodrigues, Universidade Federal de Minas Gerais
Carla J. Machado, Centro de Desenvolvimento e Planejamento Regional (CEDEPLAR)

In Brazil, a rapid decrease in fertility rates accompanied by an increase in longevity of the population has resulted in changes in the population’s morbidity-mortality profile and in health expenditures, which is known to rise with age or proximity to death. The aim of this article are (i) to measure the impact of age and proximity to death in health expenditures in the last year of life; (ii) to examine whether health expenditures are due to only one hospitalization or re-hospitalizations for the same disease; (iii) to project the health expenditures considering or not the proximity to death. The data comes from public hospitalizations of Minas Gerais (Brazil) in 2004/2005. It was observed an inverse relation between proximity to death and expenditure and that the majority of expenditure was due to re-hospitalizations for the same cause. When projecting the expenditures it was verified that the projection that does not consider the proximity to death generates higher expenditures than when we takes this variable into account.