AB0833 HOSPITAL ADMISSIONS FOR RHEUMATOID ARTHRITIS AND OTHER INFLAMMATORY POLYARTHROPATHIES IN THE BRAZILIAN PUBLIC HEALTH SYSTEM
Authors: A. Dal Pra Wendt, F. Milene Cardozo
Journal: Annals of the Rheumatic Diseases (2021)

Background: Rheumatoid arthritis is an idiopathic autoimmune disease that is characterized by symmetrical peripheral polyarthritis. The disease leads to the destruction of joints due to erosion of both bone and cartilage. The other inflammatory polyarthropathies are a group composed of 61 diseases, according to the International Classification of Diseases (ICD-10). Drug treatment is carried out through outpatient follow-up, with no need for hospitalization in mild and / or controlled cases. When surgical treatment is recommended or there are complications from rheumatoid arthritis or other inflammatory polyarthropathies, hospitalization is indicated. In addition, Brazil has a broad public health system, called the Unified Health System (UHS), responsible for most health procedures carried out at the national level, especially with regard to the socioeconomically vulnerable population. Objectives: To investigate the number of hospital admissions for rheumatoid arthritis and other inflammatory polyarthropathies in UHS during the past three years. Methods: This is a quantitative and retrospective survey based on the data available on the website of the Department of Informatics of the Brazilian Unified Health System. The data are freely accessible and public domain. Information was collected about the period between December 2017 and November 2020, referring to the number of hospitalizations for rheumatoid arthritis and other inflammatory polyarthropathies in all five regions that make up Brazil. Results: The number of hospitalizations for rheumatoid arthritis and other inflammatory polyarthropathies fluctuated, between December 2017 and November 2020, from 1083 to 1311 per month, with an average of 1184 and a total of 38228 hospitalizations over the three years analyzed. Throughout the national territory, the region with the least monthly admissions was the central-west (which comprises the states of Mato Grosso, Mato Grosso do Sul, Distrito Federal and Goiás), with 2562 total admissions and an average of 71.1 monthly admissions. In contrast, the region with the highest number of cases was the southeastern region (where the states of Espírito Santo, Minas Gerais, São Paulo and Rio de Janeiro are located), with a total of 13173 hospitalizations and a monthly average of 365.9, representing 34,4% of hospitalizations in the country. Such data is in line with the Brazilian demography, since the central-west region is the second least inhabited (with 16.09 million inhabitants) and the southeastern region is the most densely inhabited (with 80.35 million inhabitants). The number of monthly hospitalizations, which remained above 1000 from the first month analyzed (December 2017) until February 2020, dropped to 990 in March of the same year and 651 in April, maintaining an average of 678.2 in next seven months. Conclusion: It is concluded that the number of hospitalizations for rheumatoid arthritis and other inflammatory polyarthropathies in Brazil dropped significantly between March and April 2020, a period that coincides with the beginning of the COVID-19 pandemic in the country, possibly as a result both of the changes in the Brazilian medical care model (in relation to the requirements for hospitalization) and as a result of the lower demand by individuals for hospitals due to fear of contamination by the new coronavirus. References: [1]BATES, B. Propedêutica Médica . 12ª ed. Rio de Janeiro: Guanabara Koogan, 2018. Disclosure of Interests: None declared