title: Determinants of outpatient expenditure within primary care in the Brazilian National Health System.
abstract: One of the big challenges facing governments worldwide is the financing of healthcare systems. Thus, it is necessary to understand the factors and key components associated with healthcare expenditure. The aim here was to identify demographic, socioeconomic, lifestyle and clinical factors associated with direct healthcare expenditure within primary care, among adults attended through the Brazilian National Health System in the city of Bauru.
  Cross-sectional study conducted in five primary care units in Bauru (SP), Brazil.
  Healthcare expenditure over the last 12 months was assessed through medical records of adults aged 50 years or more. Annual healthcare expenditure was assessed in terms of medication, laboratory tests, medical consultations and the total. Body mass index, waist circumference, hypertension, age, sex, physical activity and smoking were assessed through face-to-face interviews.
  The total healthcare expenditure for 963 participants of this survey was US$ 112,849.74 (46.9% consultations, 35.2% medication and 17.9% laboratory tests). Expenditure on medication was associated with overweight (odds ratio, OR = 1.80; 95% confidence interval, CI: 1.07-3.01), hypertension (OR = 3.04; 95% CI: 1.91-4.82) and moderate physical activity (OR = 0.56; 95% CI: 0.38-0.81). Expenditure on consultations was associated with hypertension (OR = 1.67; 95% CI: 1.12-2.47) and female sex (OR = 1.70; 95% CI: 1.14-2.55).
  Our results showed that overweight, lower levels of physical activity and hypertension were independent risk factors associated with higher healthcare expenditure within primary care.
authors.affiliation: MSc, PhD. Researcher, Postgraduate Program on Kinesiology, Universidade Estadual Paulista (UNESP), Rio Claro (SP), Brazil.
authors.forename: Bruna Camilo
authors.initials: BC
authors.lastname: Turi
authors.affiliation: MSc, PhD. Professor, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.
authors.forename: Jamile Sanches
authors.initials: JS
authors.lastname: Codogno
authors.affiliation: MSc, PhD. Professor, Department of Food and Experimental Nutrition, Universidade de São Paulo (USP), São Paulo (SP), Brazil.
authors.forename: Flávia Mori
authors.initials: FM
authors.lastname: Sarti
authors.affiliation: PhD. Senior Research Fellow. Institute of Environment, Health and Societies, Brunel University, Uxbridge, London, United Kingdom.
authors.forename: Nana Kwame
authors.initials: NK
authors.lastname: Anokye
authors.affiliation: MSc, PhD. Researcher, Postgraduate Program on Kinesiology, Universidade Estadual Paulista (UNESP), Rio Claro (SP), Brazil.
authors.forename: Rômulo Araújo
authors.initials: RA
authors.lastname: Fernandes
authors.affiliation: MSc, PhD. Professor, Department of Physical Education, Universidade Estadual Paulista (UNESP), Bauru (SP), Brazil.
authors.forename: Henrique Luiz
authors.initials: HL
authors.lastname: Monteiro
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics*; D000886:Anthropometry; D001938:Brazil; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000191:economics; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D050177:Overweight / Q000191:economics; D011320:Primary Health Care / Q000191:economics*; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D013997:Time Factors