Association Between Continuous Cash Benefit Coverage and Hospital Admissions for Diabetes Mellitus in Brazil: An Ecological Study (2007–2024)

Título

Introdução

The Continuous Cash Benefit (BPC), established by the Organic Law of Social Assistance (LOAS), guarantees a monthly minimum wage to older adults aged 65 or over, or to individuals with disabilities of any age. To be eligible for this benefit, the per capita household income must be equal to or less than one-quarter of the minimum wage. This study examines the association between BPC coverage and hospital admissions due to diabetes mellitus (DM) in Brazil.

Objetivo

To investigate the association between Continuous Cash Benefit (BPC) coverage and hospitalization rates for diabetes mellitus in Brazil from 2007 to 2024.

Método

This ecological, cross-sectional study used secondary data extracted in March 2025. The study covered the entire Brazilian territory, with a population of 212.6 million inhabitants. Data sources included the Atlas of Human Development in Brazil and the Hospital Information System (SIH) of the Department of Informatics of the Unified Health System (DATASUS). Hospitalizations due to diabetes mellitus were identified using ICD-10 codes E10 to E14: type 1 DM, type 2 DM, malnutrition-related DM, other specific types, and unspecified DM. Hospitalization rates were calculated by dividing the number of DM-related hospital admissions in each federative unit and year by the corresponding population, multiplied by 100,000 inhabitants. Population data were obtained from DATASUS. Data processing was performed using Microsoft Excel. Spatial autocorrelation (Global Moran's I) and hotspot analysis (Getis-Ord Gi) were conducted using GeoDa software. Regression analysis was performed in R using the spdep package. A Generalized Linear Model (GLM) was used to assess the association between BPC coverage and hospitalization rates.

Resultados

A total of 2,327,162 hospital admissions for DM were recorded in Brazil between 2007 and 2024, corresponding to a rate of 63.87 admissions per 100,000 inhabitants. In the bivariate GLM analysis, BPC coverage was significantly associated with hospitalization rates for diabetes mellitus (p = 0.01).

Conclusão

The analysis revealed a statistically significant association between BPC coverage and DM-related hospital admissions. These findings suggest that social protection mechanisms, such as the BPC, may influence healthcare utilization patterns among vulnerable populations.

Palavras Chave

Diabetes Mellitus; Hospitalization; Health Equity