Cost of diseases related to alcohol consumption in the Brazilian Unified Health System

Coutinho, Evandro Silva Freire; Bahia, Luciana; Barufaldi, Laura Augusta; Abreu, Gabriela de Azevedo; Malhão, Thainá Alves; Pepe, Camila Ribeiro; Araujo, Denizar Vianna

doi:10.1590/S1518-8787.2016050005741

Evandro Silva Freire Coutinho

Escola Nacional de Saúde Pública. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil

Luciana Bahia

Departamento de Medicina Interna. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil

Laura Augusta Barufaldi

Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde. Secretaria de Vigilância em Saúde. Ministério da Saúde. Brasília, DF, Brasil

Gabriela de Azevedo Abreu

Instituto de Estudos em Saúde Coletiva. Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil

Thainá Alves Malhão

Unidade Técnica de Alimentação, Nutrição e Câncer. Coordenação de Prevenção e Vigilância. Instituto Nacional de Câncer José Alencar Gomes da Silva. Rio de Janeiro, RJ, Brasil

Camila Ribeiro Pepe

Medinsight Decisions in Health Care. São Paulo, SP, Brasil

Denizar Vianna Araujo

Departamento de Medicina Interna. Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil

Correspondence
: Evandro Silva Freire Coutinho. Escola Nacional de Saúde Pública – Fiocruz. Rua Leopoldo Bulhões, 1480 Manguinhos. 21041-210 Rio de Janeiro, RJ, Brasil. E-mail: esfcoutinho@gmail.com

Author’s Contribution: Conceptualization: LB, ESFC, DVA. Design: LB, ESFC, DVA. Data analysis and interpretation: LB, ESFC, DVA. Contribution for data collection, analysis, and interpretation: LAB, GAA, TAM, PCR. Manuscript elaboration: LB, ESFC, DVA, LAB, GAA, TAM, PCR. All the authors approved the final version of the article.

Conflict of Interest: The authors declare no conflict of interest.

Disease	25 g/day RR	50 g/day RR	100 g/day RR	Study Meta-analysis*	Period covered	N and type of included studies; Total sample size	AMSTAR
Oropharyngeal cancer	1.86 1.73	3.11 2.77	6.45 5.75	Corrao et al.² (2004) Bagnardi et al.¹ (2001)	1966-1998 1966-2000	14 CC, 01 CO; 4507 25 CC, 01 CO; 7954	9/11 4/11
Esophageal cancer	1.39 T: 1.51 M: 1.43 F: 1.52	1.93 T: 2.21 M: 1.98 F: 2.24	3.59 T: 4.23 M: 3.49 F: 4.45	Corrao et al.² (2004) Bagnardi et al.¹ (2001)	1966-1998 1966-2000	13 CC, 01 CO; 3233 17 CC, 1 CO; 7239 17 CC, 01 CO; 3310 05 CC; 304	9/11 4/11
Laryngeal cancer	1.43 1.35	2.02 1.83	3.86 3.24	Corrao et al.² (2004) Bagnardi et al.¹ (2001)	1966-1998 1966-2000	20 CC; 3789 20 CC; 3759	9/11 4/11
Liver cancer	1.19 T: 1.20 M: 1.28 F: 1.97	1.40 T: 1.41 M: 1.51 F: 3.57	1.81 T: 1.83 M: 1.62 F: 9.15	Corrao et al.² (2004) Bagnardi et al.¹ (2001)	1966-1998 1966-2000	08 CC, 02 CO; 1321 16 CC, 03 CO; 1961 08 CC, 02 CO; 949 02 CC, 01 CO; 231	9/11 4/11
Breast cancer	1.25 1.31	1.55 1.67	2.41 2.71	Corrao et al.² (2004) Bagnardi et al.¹ (2001)	1966-1998 1966-2000	24 CC, 05 CO; 32175 37 CC, 12 CO; 44033	9/11 4/11
Hypertension	1.43	2.04	4.15	Corrao et al.² (2004)	1966-1998	02 CO, 5801	9/11
Cirrhosis	2.90	7.13	26.52	Corrao et al.² (2004)	1966-1998	06 CC, 03 CO; 2202	9/11
Chronic pancreatitis	1.34	1.78	3.19	Corrao et al.² (2004)	1966-1998	02 CC, 247	9/11

Capital	Laryngeal cancer	Oropharyngeal cancer	Esophageal cancer	Liver cancer	Hypertension	Cirrhosis	Chronic pancreatitis

	PAR (%)	PAR (%)	PAR (%)	PAR (%)	PAR (%)	PAR (%)	PAR (%)
Porto Velho	4.98	8.75	4.17	3.03	4.58	17.48	3.65
Rio Branco	4.98	8.75	4.17	3.03	4.58	17.48	3.65
Manaus	5.74	10.03	4.81	3.50	5.28	19.76	4.22
Boa Vista	4.98	8.75	4.17	3.03	4.58	17.48	3.65
Belem	4.98	8.75	4.17	3.03	4.58	17.48	3.65
Macapa	4.98	8.75	4.17	3.03	4.58	17.48	3.65
Palmas	4.68	8.25	3.92	2.84	4.30	16.57	3.43
Sao Luis	7.71	13.26	6.48	4.74	7.10	25.24	5.70
Teresina	7.45	12.84	6.26	4.58	6.86	24.56	5.50
Fortaleza	7.96	13.66	6.69	4.90	7.33	25.89	5.88
Natal	7.10	12.27	5.97	4.36	6.54	23.61	5.24
Joao Pessoa	7.19	12.42	6.04	4.41	6.62	23.86	5.31
Recife	9.20	15.64	7.76	5.69	8.48	29.06	6.83
Maceio	7.45	12.84	6.26	4.58	6.86	24.56	5.50
Aracaju	5.61	9.80	4.70	3.42	5.16	19.37	4.12
Salvador	7.45	12.84	6.26	4.58	6.86	24.56	5.50
Belo Horizonte	6.78	11.74	5.69	4.15	6.24	22.72	5.00
Vitoria	7.53	12.97	6.33	4.63	6.94	24.77	5.56
Rio de Janeiro	6.05	10.54	5.07	3.69	5.56	20.65	4.45
Sao Paulo	3.68	6.53	3.07	2.22	3.37	13.37	2.69
Curitiba	3.74	6.63	3.12	2.26	3.43	13.57	2.73
Florianopolis	2.46	4.41	2.05	1.48	2.25	9.24	1.79
Porto Alegre	4.26	7.52	3.56	2.58	3.91	15.24	3.12
Campo Grande	4.24	7.50	3.55	2.57	3.90	15.19	3.11
Cuiaba	4.24	7.50	3.55	2.57	3.90	15.19	3.11
Goiania	4.24	7.50	3.55	2.57	3.90	15.19	3.11
Brasilia	6.02	10.49	5.04	3.67	5.53	20.56	4.43

Capital	Laryngeal cancer	Oropharyngeal cancer	Esophageal cancer	Breast cancer	Liver cancer	Hypertension	Cirrhosis	Chronic pancreatitis

	PAR (%)	PAR (%)	PAR (%)	PAR (%)	PAR (%)	PAR (%)	PAR (%)	PAR (%)
Porto Velho	1.47	2.66	1.23	0.66	2.99	1.35	5.70	1.07
Rio Branco	1.47	2.66	1.23	0.66	2.99	1.35	5.70	1.07
Manaus	1.47	2.66	1.23	0.66	2.99	1.35	5.70	1.07
Boa Vista	1.47	2.66	1.23	0.66	2.99	1.35	5.70	1.07
Belem	1.82	3.28	1.51	0.82	3.68	1.67	6.96	1.32
Macapa	1.47	2.66	1.23	0.66	2.99	1.35	5.70	1.07
Palmas	1.38	2.49	1.15	0.62	2.80	1.26	5.34	1.00
Sao Luis	4.02	7.11	3.35	1.83	7.95	3.69	14.46	2.94
Teresina	2.26	4.06	1.88	1.02	4.55	2.07	8.54	1.64
Fortaleza	2.44	4.38	2.04	1.11	4.92	2.24	9.20	1.78
Natal	2.16	3.88	1.80	0.98	4.36	1.98	8.20	1.57
Joao Pessoa	0.92	1.67	0.77	0.41	1.88	0.84	3.63	0.67
Recife	2.35	4.23	1.96	1.07	4.74	2.16	8.88	1.71
Maceio	2.26	4.06	1.88	1.02	4.55	2.07	8.54	1.64
Aracaju	1.99	3.58	1.66	0.90	4.02	1.82	7.59	1.45
Salvador	2.26	4.06	1.88	1.02	4.55	2.07	8.54	1.64
Belo Horizonte	3.32	5.91	2.77	1.51	6.61	3.04	12.18	2.42
Vitoria	3.66	6.50	3.06	1.67	7.28	3.36	13.32	2.68
Rio de Janeiro	2.84	5.09	2.37	1.29	5.70	2.61	10.58	2.07
Sao Paulo	1.11	2.01	0.92	0.50	2.26	1.01	4.33	0.80
Curitiba	0.80	1.46	0.67	0.36	1.64	0.73	3.16	0.58
Florianopolis	1.90	3.42	1.58	0.86	3.84	1.74	7.26	1.38
Porto Alegre	2.56	4.58	2.13	1.16	5.13	2.34	9.59	1.86
Campo Grande	2.08	3.73	1.73	0.94	4.19	1.90	7.89	1.51
Cuiaba	2.08	3.73	1.73	0.94	4.19	1.90	7.89	1.51
Goiania	2.08	3.73	1.73	0.94	4.19	1.90	7.89	1.51
Brasilia	1.75	3.15	1.45	0.79	3.54	1.60	6.70	1.27

Hospitalization costs (US$)^b	Hospitalization costs (US$) attributable to risk factors (%)	Ambulatory costs (US$)^b (medical visits, exams, procedures)	Ambulatory costs (US$) attributable to risk factors (%)	Total costs (US$)^b Outpatient and Inpatient care	Total costs (US$) attributable to risk factors (%)
Women		Women		Women
41,6 million	571,3 thousand (1.37%)	218,2 million	1,7 million (0.82%)	259,8 million	2,3 million (0.91%)
Men		Men		Men
42,7 million	3,2 million (7.67%)	41,5 million	2,6 million (6.33%)	84,2 million	5,9 million (7.01%)
Total		Total		Total
84,3 million	3,8 million (4,56%)	259,7 million	4,4 million (1.70%)	344,1 million	8,2 million (2.40%)

Disease	Hospitalization costs US$^b	Ambulatory costs US$	Total US$
Breast cancer	136,1 thousand	1,4 million	1,6 million
Oropharyngeal cancer	1,1 million	1,6 million	2,7 million
Laryngeal cancer	277,5 thousand	367,4 thousand	645,0 thousand
Esophageal cancer	368,4 thousand	385,2 thousand	753,6 thousand
Liver cancer	70,8 thousand	21,9 thousand	92,8 thousand
Hypertension	630,8 thousand	443,4 thousand	1 million
Cirrhosis	1,2 million	10,0 thousand	1,2 million
Chronic pancreatitis	18,5 thousand	24,4 thousand	42,9 thousand
Total	3,8 million	4,4 million	8,2 million

[1] Correspondence
: Evandro Silva Freire Coutinho. Escola Nacional de Saúde Pública – Fiocruz. Rua Leopoldo Bulhões, 1480 Manguinhos. 21041-210 Rio de Janeiro, RJ, Brasil. E-mail: esfcoutinho@gmail.com

Brasil

Brasil

Cost of diseases related to alcohol consumption in the Brazilian Unified Health System

Custos de doenças relacionadas ao consumo de álcool no Sistema Único de Saúde

ABSTRACT

OBJECTIVE

METHODS

RESULTS

CONCLUSIONS