O efeito do status de sobrevivência sobre gastos com interna？？es hospitalares públicas no Brasil em uma perspectiva temporal

health care spending projections point to a considerable increase in expenditure due to population aging. however, studies show that healthcare spending is concentrated at the end of life. therefore, expenditure projections that do not take proximity to death into account tend to be overestimated. the aim of this paper is to analyze the amount of spending on public inpatient care in brazil by survivorship status and determine if there is a relationship between inpatient costs for individuals close to death and age at death. we used data about hospital admissions over the years 1995 to 2007 from sistema de informa？？es hospitalaresdo sistema único de saúde - sih/sus (hospital system information from unified health system), an administrative record from the federal government that includes information on all public hospitalizations in brazil. survivorship status is given by those who survived in the year of analysis (survivors) and for those who died in the same period (decedents). we analyzed inpatient expenditure trends over time by age group for survivors and decedents, and the ratio of decedents/survivors costs. projections of inpatient expenditures in 2050 were performed by the multiplication of per capita inpatient costs by age by the projected number of hospitalizations in each age group. in order to analyze the effect of survival status on hospital spending, we first estimated the number of decedents and survivors in each age group in the future, and then we multiplied these numbers through the per capita expenditure by survivorship status and age. the results show that the pattern of expenditure by survivorship status in brazil follows the pattern found in other countries: for survivors expenditures increase with age and for decedents there is a downward trend by age. the ratio decedents/survivors cost has a negative relationship with age but increases over time. applying the age profile of the average expenditure for 2007 results in a projected increase of ov