Gunshot wounds cost the SUS R$900 million – 11/01/2023 – Balance and Health

Hospitalizations of victims with injuries caused by firearms cost the SUS (Unified Health System) R$886 million in the last 15 years. The data is part of a survey by the Sou da Paz Institute, which points to armed violence as the cause of approximately 300,000 hospitalizations in the country between 2008 and 2022.

According to the study, statistics have shown a downward trend since 2018, but remain at a high level. Last year, the public health system disbursed R$41 million for hospital care for 17,100 people shot, according to data from the SIH (Hospital Information System) of the SUS. The amount would be enough to cover almost 1 million mammograms or 10 million complete blood counts.

“The cost of each hospitalization due to a firearm is 3.2 times greater than the federal expenditure on health per capita per year. This shows that these are very complex cases, and that, despite the drop, it continues to be a high value in proportion to what is spent on health”, says Carolina Ricardo, executive director of Sou da Paz.

In 2022, the average value of hospitalization for assault with a firearm was R$2,391, while federal public expenditure per capita was R$737.89. The value does not reflect the totality of public spending on care for these victims, as states and municipalities have their own health expenses.

The research attributes the drop in spending on hospitalizations to a set of factors, such as the decrease in violent crimes, the lag in reference prices in the SUS table and the severity of the cases that required care. “When we look at the most serious cases, which are the most expensive [para o sistema de saúde]they have also fallen a lot in recent years”, says Ricardo.

More complex hospitalizations tend to last longer and often require more medical procedures. These are cases in which the victim suffered, for example, trauma to the head, chest or organs inside the abdomen – injuries that often lead to death. Less serious cases consider injuries, for example, to arms and legs.

High lethality cases stopped being predominant in 2015, according to the survey, and have continued to decline since then. Hospitalizations of less serious patients, on the other hand, have increased in the last two years, after a sharp drop between 2017 and 2020. Last year, low-severity cases represented 44% of hospitalizations compared to 27% of more serious cases – there are still 29% of cases of “intermediate” severity.

For the Sou da Paz researcher, this variation may be associated with the greater circulation of weapons in the country, resulting from easier access for the civilian population during the government of Jair Bolsonaro (PL).

“One hypothesis is that this type of hospitalization could be the result of more common situations, when someone shoots in a fight, for example, which is something different from an execution. It also caught my attention that in the South and Central-West regions, the The percentage of accidents is higher than in other regions, and these are areas that have a high concentration of firearms”, adds Ricardo.

Across the country, intentional assaults prevail as the main cause of firearm injuries, accounting for 75% of cases. Accidents, in turn, were cited as the cause in 17% of incidents.

The regions cited by the researcher were the only ones in which accidents were above the national average – 32% in the center-west and 26% in the south.

The research also shows that 9 out of 10 patients hospitalized for armed violence in Brazil are men. Young people account for just over half of the victims and black people account for 57%.

The black population is precisely the one with the most deficient health system, according to Sou da Paz. “The availability of human resources in terms of anesthetists and surgeons, fundamental for assistance in cases of accidents and violence in the network hospital of the SUS, presents a pattern in terms of its spatial distribution: the number of professionals is lower in states where the black population is more represented”, says the study.