Sleep pattern, obesity and healthcare expenditures in Brazilian adults / Padrões do sono, obesidade e despesas em saúde com brasileiros adultos

Abstract The aim of this study was to analyze the relationship between sleep pattern and healthcare expenditures in adults, as well as to identify whether physical activity, biochemical markers and obesity affect this relationship. The sample was composed of 168 adults aged ≥ 50 years attended by two Basic Healthcare Units in Presidente Prudente, SP, Brazil. Health expenditure, sleep pattern, anthropometry, adiposity index, physical activity, metabolic and cardiovascular variables were assessed. Statistical analyses were performed using Kruskal-Wallis, Mann-Whitney and Spearman tests. Sleep disorders were positively correlated to higher costs with medicines and negatively correlated to costs with laboratory tests, even after adjusts by confounders. In addition, healthcare costs were also correlated to physical activity score, blood pressure, obesity and metabolic variables. Severe sleep disorders and high percentage of body fat were associated with increased use of medications. Sleep pattern is correlated to primary care healthcare costs, obesity and physical activity level.

Resumo O objetivo deste estudo foi analisar a relação entre padrão de sono e despesas de saúde em adultos, bem como identificar se atividade física, marcadores bioquímicos e obesidade afetam esse relacionamento. A amostra foi composta por 168 adultos com idade ≥ 50 anos atendidos por duas unidades básicas de saúde em Presidente Prudente, SP, Brasil. Foram avaliadas as despesas de saúde, padrões do sono, antropometria, atividade física, variáveis metabólicas e cardiovasculares. Foram utilizados Kruskal-Wallis, Mann-Whitney e Spearman. Os distúrbios do sono foram correlacionados positivamente com os custos mais elevados com medicamentos e negativamente com os custos com testes laboratoriais, mesmo após ajuste por fatores de confusão. Além disso, os custos de saúde também foram correlacionados ao escore de atividade física, pressão arterial, obesidade e variáveis metabólicas. Distúrbios graves do sono e alta porcentagem de gordura corporal foram associados ao aumento do uso de medicamentos. O padrão de sono está correlacionado com os custos de cuidados de saúde primários, obesidade e atividade física.

Association between sleep disorders and chronic diseases in patients of the brazilian national health system / Associação entre distúrbios do sono e doenças crônicas em pacientes do sistema único de saúde

ABSTRACT Many factors are associated with sleep disorders, causing an increase in health spending. The objective of this study was to analyze the association of sleep disorders and non-communicablechronic diseases in patients over 50 years of age, attended by Basic Health Care Units of Presidente Prudente. In total, 363 patients participated. The history of diseases was self-reported through the use of a questionnaire, the level of physical activity was evaluated by the Baecke questionnaire, and sleep quality was assessed using the Mini-Sleep Questionnaire. Anthropometric and body composition data were collected using a stadiometer and scale; patients in the highest (75th) percentile were considered obese. Statistical analysis was performed using the Student t test, chi-square test, and binary logistic regression. The results showed that sleep disorders are associated with osteoporosis, arthritis/osteoarthritis, low back pain, depression, and obesity. Additionally, obesity and physical inactivity influence the occurrence of non-communicable chronic diseases.

RESUMO Inúmeros fatores estão associados aos distúrbios do sono ocasionando o aumento nos gastos com saúde. O objetivo do trabalho foi analisar a associação dos distúrbios do sono e doenças crônicas não transmissíveis em pacientes com idade superior a 50 anos atendidos por Unidades Básicas de Saúde de Presidente Prudente. Participaram 363 pacientes. O histórico de doenças foi auto relatada a partir da aplicação de questionário, o nível de atividade física foi verificado através do questionário de Baecke, e a qualidade do sono foi avaliada utilizando o Mini-Sleep questionnaire. Dados antropométricos e de composição corporal foram coletados utilizando estadiômetro e balança, foram considerados obesos os pacientes dentro do percentil 75. A análise estatística foi composta pelos testes t de Student, qui-quadrado, e regressão logística binária. Os resultados mostraram que o distúrbio do sono está associado as doenças osteoporose, artrite/artrose, dor lombar, depressão e obesidade. Adicionalmente obesidade e inatividade física influenciam na ocorrência de doenças crônicas não transmissíveis.

Association between osteoporosis, health-related productivity loss and use of hospital services in outpatients of the Brazilian National Health System

Aims: To analyze factors associated with osteoporosis among outpatients of the Brazilian National Health System and to identify their association with hospital and labor economic outcomes. Methods: Cross-sectional study carried out in the city of Presidente Prudente / SP. The sample consisted of 542 adults of both sexes and aged ≥ 50 years old. The occurrence of osteoporosis, health-related productivity loss, use of hospital services and level of physical activity were assessed using questionnaires. Statistical analysis was composed of chi-square test, binary logistic regression and Mann-Whitney test. The significance level adopted was p-value <0.05. Results: The prevalence of osteoporosis was 14.4% (95% CI: 11.4% - 17.3%) and it was associated with female sex (p = 0.001), lower economic status (p-value = 0.036) and obesity (p-value = 0.003). Participants with osteoporosis showed a higher incidence of surgery in the last 12 months (OR = 2.13 [1.04 to 4.35]), productivity loss (OR = 1.91 [1.13 to 3.42]) and disability retirement (OR = 2.03 [1.20 to 3.43]). Over the past 12 months, the sum of direct and indirect economic loss was R$ 1,382,630.00. Conclusion: The female sex, lower economic status and obesity were associated with a higher occurrence of osteoporosis, and consequent higher use of hospital services and significant economic losses.(AU)