ANALYSIS OF HOSPITAL MORBIDITY FROM CARDIOVASCULAR DISEASES IN BRAZIL: A TIME SERIES STUDY FROM 2008 TO 2024
Hospitalization. Cardiovascular Diseases. Unified Health System. Time Series Studies. Public Health.
Cardiovascular diseases are the leading cause of mortality and disability in Brazil and worldwide. Among premature deaths from chronic diseases, 38% occurred due to these causes. They are influenced by social, environmental, behavioral, and metabolic factors, requiring expanded care in healthcare networks and various technologies. The study aims to analyze the hospital morbidity of cardiovascular diseases in Brazil in the time series from 2008 to 2024. This is an ecological study with an analytical approach and a time series, using data from the Department of Information and Informatics of the Unified Health System. Hospitalizations under chapter IX of the ICD-10 between 2008 and 2024 were considered. Data collection and updating took place in April 2025. The dependent variables were hospitalizations. The independent variables were: length of stay; hospitalization costs; gender; race; age group (30 to 49 years) and cause of hospitalization (acute myocardial infarction and stroke). The data were analyzed using the Joinpoint Regression Program to obtain linear regression and temporal analysis of the variables. It was found that the hospitalization rate for cardiovascular diseases in Brazil varied from 573.28 hospitalizations per 100,000 inhabitants in 2008 to 623.58 in 2024. The lowest rate was recorded in 2021, at the beginning of the COVID-19 pandemic, with 480.24 hospitalizations per 100,000 inhabitants. Hospitalization costs increased throughout the period, both in Brazil and in the regions. There was an increase in the length of stay, ranging from 3,706.36 days per 100,000 inhabitants in 2008, reaching its peak in 2024, with 4,010.22 days per 100,000 inhabitants, demonstrating that, despite periods of decline in hospitalizations, costs continued to rise, indicating greater severity of hospitalizations. Analysis by sex shows similarity in the trend of general hospitalizations in the time series; however, males have higher rates, but the decline in hospitalizations during the pandemic period and growth after 2021 was more pronounced for females, indicating gender disparities in cardiovascular care. White race/color followed a downward trend in hospitalizations until 2021, followed by growth. For brown race/color, the main trend is growth in hospitalizations, and for black race/color, there are variations in the trend of growth and decline over time, suggesting racial inequalities and the need for improved records. The 30-49 age group showed a marked downward trend until 2021, when it began to rise, indicating the need for cardiovascular prevention policies for young adults. Hospitalizations for stroke showed a general upward trend, with a period of decline in Brazil and the north and northeast regions, which includes the early years of the pandemic. Hospitalizations for acute myocardial infarction increased significantly throughout the period in Brazil and its regions. It can be concluded that there was a trend toward an increase in hospitalizations for these conditions between 2008 and 2024 in Brazil and its regions, as well as in costs and length of stay, highlighting the need to strengthen health promotion and cardiovascular prevention policies. Differences by sex and race highlight inequalities and the importance of improving health records with a focus on regional trends, which underscore the relevance of strengthening health care networks and the central role of primary care in cardiovascular health care.