Cystic fibrosis demographics and healthcare resource utilization in the Brazilian healthcare system

Objective: To describe the demographic characteristics and hospital healthcare resource utilization (HCRU) in people with cystic fibrosis (CF) in Brazil before the introduction of CF Transmembrane Conductance Regulator modulators, using a public health database system. Methods: This retrospective, cross-sectional study described demographic characteristics of people with CF using the Outpatient Procedure Information System (SIA) and the Hospital Admission Information System (SIH) databases from 2015 to 2019. Patients were identified in the SIH in each year using the International Classification of Diseases (ICD-10) code E84. For the SIA, in addition to ICD-10, the record of ≥ 1 prescription of dornase alfa, pancreatic enzymes, or inhaled tobramycin in that year was also considered. All analyses were descriptive and stratified by age. Results: The number of people with CF in the SIA database increased from 3,737 in 2015 to 4,048 in 2019. Across all years, about half of the population was male (range: 51.4%-52.8%), aged ≥ 12 years, and resided in the southeast region. The number of hospitalizations increased from 1,300 in 2015 to 1,508 in 2019. Annual hospitalization rates per patient were higher among the youngest (<6 years) and oldest (≥18 years) age groups than in the ≥ 6 to < 18-year age group. Most hospitalizations (>80%) required treatment for pulmonary manifestations, and the average length of stay ranged from 11 to 15 days. Conclusion: CF poses substantial HCRU burden to the public health system in Brazil. This study showed that people with CF had a high rate of hospitalizations with lengthy stays per hospitalization.