Qualidade do sono e gastos com saúde de pacientes atendidos pelo Sistema Único de Saúde: o papel da atividade física
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Data
2018-03-26
Autores
Silva, Eduardo Pereira da [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A qualidade do sono tem sido apontada como importante variável associada à manutenção da saúde e redução de despesas com serviços de saúde. No entanto, pouco se sabe sobre a relação entre qualidade do sono, alterações metabólicas e efeito da prática de atividades físicas, bem como o impacto desses fatores para os custos com saúde no âmbito do Sistema Único de Saúde (SUS). Objetivos: Analisar a relação entre qualidade do sono e gasto com saúde de pacientes do SUS, bem como identificar se estas relações ocorrem independentemente da prática de atividades físicas e fatores associados. Métodos: A amostra foi composta por 168 adultos de ambos os sexos (52 homens [31%] e 116 mulheres [69%]) com média de idade de 63,8 ± 8,6 anos, atendidos por duas unidades básicas de saúde da cidade de Presidente Prudente/SP. A variável dependente analisada foi os gastos em saúde. Como variáveis independentes foram analisados: i) indicadores de adiposidade corporal: percentil de gordura, circunferência de cintura e índice de massa corporal; ii) variáveis hemodinâmicas: pressão arterial sistólica e diastólica, glicemia, colesterol total, lipoproteínas de alta e baixa densidade, e triglicérides; iii) qualidade do sono e iv) a prática de atividade física. Adicionalmente, foram consideradas as variáveis de ajuste: sexo, idade e condição econômica. As análises estatísticas foram realizadas com testes de Kruskal-Wallis, Mann-Whitney e Spearman. Resultados: Alterações nos padrões do sono foram positivamente correlacionados com gastos com medicamentos r= 0,213 [95%IC= 0,052- 0,363] e negativamente com gastos com exames r= -0,166 [95%IC= -0,313- -0,012] (p-valor= -0,152), mesmo após ajuste por fatores de confusão. Além disso, os gastos com serviços de saúde também foram correlacionados ao escore de atividade física (p-valor= 0,162), pressão arterial (p-valor= -0,164), e variáveis bioquímicas. Conclusão: A qualidade do sono está correlacionada com os gastos de cuidados em saúde no Sistema Único de Saúde, mesmo após ajuste do modelo por variáveis de confusão, com destaque para gastos com medicamentos e exames.
Sleep quality has been identified as an important variable related to the maintenance of health and reduction of expenses with health services. However, little is known about the relationship between sleep quality, metabolic changes and the effect of physical activity practice, as well as the impact of these factors on health costs within the Unified Health System (UHS). Objectives: To analyze the relationship between sleep quality and health expenditure of UHS patients, as well as their activities related to the practice of associated physical and physical activities. Methods: The test was performed by 168 adults of both sexes (52 men [31%] and 116 women [69%]) with mean age of 63.8 ± 8.6 years, attended by two basic health units city of Presidente Prudente/SP. A dependent variable analyzed was health spending. The measures of confidence were: i) indicators of body adiposity: fat percentile, waist circumference and body mass index; ii) hemodynamic variables: systemic and diastolic arterial hypertension, glycemia, total cholesterol, high and low density lipoproteins, and triglycerides; iii) quality of sleep and iv) a practice of physical activity. Additionally, adjustment variables were found: gender, age and economic matrix. The analyzes consist of Kruskal-Wallis, MannWhitney and Spearman tests. Results: changes in the patterns were positively correlated with drug expenditures r = 0.213 [95% CI = 0.052-0.363] and with the negative shift with exams r = -0.166 [95% CI = -0.313-0.012] (p = value = -0.152), even if adjusted for confounding factors. In addition, health expenditures were correlated to the physical activity score (p-value = 0.162), arterial measure (p-value = -0.164), and biochemical variables. Conclusion: Sleep quality correlates with health care expenditures in the Unified Health System, even with the change in the model of basic variables, with emphasis on drug and testing expenditures.
Sleep quality has been identified as an important variable related to the maintenance of health and reduction of expenses with health services. However, little is known about the relationship between sleep quality, metabolic changes and the effect of physical activity practice, as well as the impact of these factors on health costs within the Unified Health System (UHS). Objectives: To analyze the relationship between sleep quality and health expenditure of UHS patients, as well as their activities related to the practice of associated physical and physical activities. Methods: The test was performed by 168 adults of both sexes (52 men [31%] and 116 women [69%]) with mean age of 63.8 ± 8.6 years, attended by two basic health units city of Presidente Prudente/SP. A dependent variable analyzed was health spending. The measures of confidence were: i) indicators of body adiposity: fat percentile, waist circumference and body mass index; ii) hemodynamic variables: systemic and diastolic arterial hypertension, glycemia, total cholesterol, high and low density lipoproteins, and triglycerides; iii) quality of sleep and iv) a practice of physical activity. Additionally, adjustment variables were found: gender, age and economic matrix. The analyzes consist of Kruskal-Wallis, MannWhitney and Spearman tests. Results: changes in the patterns were positively correlated with drug expenditures r = 0.213 [95% CI = 0.052-0.363] and with the negative shift with exams r = -0.166 [95% CI = -0.313-0.012] (p = value = -0.152), even if adjusted for confounding factors. In addition, health expenditures were correlated to the physical activity score (p-value = 0.162), arterial measure (p-value = -0.164), and biochemical variables. Conclusion: Sleep quality correlates with health care expenditures in the Unified Health System, even with the change in the model of basic variables, with emphasis on drug and testing expenditures.
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Palavras-chave
Atividade física, Gastos com saúde, Physical activity, Health expenditures, Saúde pública, Qualidade do sono, Sleep quality, Public health