Assessing burn care in Brazil: An epidemiologic, cross-sectional, nationwide study

Abstract

Background: The aim of this study was to describe the national epidemiology of burns in Brazil and evaluate regional access to care by defining the contribution of out-of-hospital mortality to total burn deaths. Methods: We reviewed admissions data for Brazil's single-payer, free-at-point-of-care, public-sector provider and national death registry data abstracted from DATASUS for 2008-2014. Admissions, in hospital mortality, hospital reimbursement, and total deaths from the death registry were assessed for records coded under ICD-10 codes corresponding to flame, scald, contact, and electrical burns. Results: A total of 17,264 burn deaths occurred between 2008-2014 (mean annual 2,466 [SD 202]). Of all burns deaths 79.1% occurred out of hospital, with marked regional differences in the proportion of out-of-hospital deaths (P < 0.001), the greatest being in the North region. The mean annual number of admissions >24 hours was 18,551 (SD 1,504) with the greatest prevalence of flame burns overall (43.98%) and scalds prevailing in < 5 years (57.8%). Regional differences were found in per-capita admissions (P < 0.001) with the greatest number in the Central-West region. A mean of $1,022 (SD $94) US dollars was reimbursed per burn admission. Conclusion: Given that nearly 80% of burns mortalities occurred out of hospital, prevention of burns along-side interventions improving prehospital and access to care have potential for the greatest impact.