Custos da gravidez no Brasil: um estudo retrospectivo descritivo pela perspectiva do sistema público de saúde

Abstract

Introduction: Among the current United Nations Sustainable Development Goals, health and well-being stand out, with the primary goal of reducing the global maternal mortality rate. Maternal and child health impacts the health and quality of life of a generation, so monitoring the costs associated with their care is imperative for managers and decision-makers in public resources. As physical therapy is a profession capable of improving the quality of life of pregnant women, knowing the relative scale of its consumption in health is fundamental. Objective: To estimate the healthcare costs for usual-risk pregnancy and medium-risk comorbidities associated with pregnancy from the perspective of the Unified Health System in Brazil, considering different regions of the country and the age of the pregnant woman. Methods: This retrospective descriptive cost-of-illness study included data of pregnant women and teenagers aged between 15 and 40 years from all states in the country, unless they presented a high-risk pregnancy, using the International Classification of Diseases codes. Data on resource use and their respective costs were extracted from the Hospital and Outpatient Information System, through DATASUS, using the TABWIN application, from the Brazilian Ministry of Health, for the year 2023. Costs were converted to international dollars, using purchasing power parity. Data analysis was performed descriptively. Results: A total of 515,113 resource uses and $24,015,741 in total expenditures were found, considering both health systems. The outpatient system had 403,801 uses and $2,060,262, and the hospital system had 111,312 uses and $21,955,479. Usual-risk pregnancies accounted for 389,532 resource uses and $2,813,607 in expenditures, while medium-risk pregnancies with comorbidities accounted for 125,581 resource uses and $21,202,134 in expenditures. The southeast region consumed the most resources in both systems. In the outpatient system, the northern region had the lowest resource use and costs. In the hospital system, the midwest region had lower resource use and the south had lower costs. The age group that consumed the most resources in both systems was from 20 to 29 years, and the one that consumed the least was from 15 to 19 years. Physical therapy showed resource use and costs only for the treatment of venous complications in pregnancy in the outpatient system. For the other codes surveyed in the hospital and outpatient systems, no consumption was identified. Conclusion: Healthcare costs with usual-risk pregnancies and medium-risk comorbidities associated with pregnancy, from the perspective of the Unified Health System in Brazil, were $24,015,741. Final considerations: This study provides data for understanding the distribution of public spending with usual-risk pregnancies and medium-risk comorbidities associated with pregnancy, which is essential for decisions and public policies on maternal health.