Regional Inequalities in Epilepsy Hospitalizations in Brazil’s Unified Health System, 2014–2024
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Abstract
Introduction: epilepsy imposes a health and social burden. In Brazil, territorial and sociodemographic inequalities may influence hospital utilization within the Unified Health System (Sistema Único de Saúde, SUS).
Objective: to describe the regional distribution by place of hospitalization and the sociodemographic distribution of epilepsy-related hospitalizations recorded in the SUS between 2014 and 2024, and to characterize the proportion of emergency hospitalizations and in-hospital case fatality.
Methods: this ecological, descriptive, quantitative study was based on secondary data from the SUS Hospital Information System, obtained from DATASUS. Hospitalizations with a primary diagnosis of epilepsy (ICD-10: G40) were included. The unit of analysis was the hospitalization, not the patient. Region of hospitalization, sex, age group, race/skin color, type of admission, hospitalizations, and in-hospital deaths were analyzed using descriptive statistics.
Results: overall, 610,247 hospitalizations were recorded; 564,557 were emergency hospitalizations (92.5%) and 45,690 were elective (7.5%). The Southeast accounted for 253,736 records (41.6%), followed by the Northeast and South. Men accounted for 57.7%. The 1–4-year age group had the highest frequency (100,134; 16.4%). Individuals recorded as Brown (parda) accounted for 42.1%, although race/skin color information was missing for 18.6% of records. There were 15,481 in-hospital deaths, with an approximate in-hospital case-fatality rate of 2.5%.
Conclusions: Recorded hospitalizations show important regional and sociodemographic differences. The predominance of emergency hospitalizations underscores the need to strengthen outpatient follow-up, continuity of care, and epilepsy care networks. The findings represent recorded hospitalization events, not population prevalence or individual patients.
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