Health · Medical Research · 11 hrs ago
Primary care linked to fewer hospital stays for older adults in Brazil’s SUS
A study of 9,058 Brazilians aged 50 and older examined chronic illnesses and hospital stays in the country’s public and private health systems.
In the public SUS system, better-rated primary care weakened the link between multiple illnesses and hospital stays.
In private health plans, the pattern was reversed, with better ratings not linked to a weaker connection.
The study counted people as having multiple chronic illnesses if they reported at least two of 13 conditions, including diabetes, hypertension and depression.
SUS primary care teams serve defined communities and are expected to coordinate care over time, while private-plan patients more often have direct access to specialists and hospitals.
That difference matters because older people with several conditions may need coordinated follow-up, not a series of disconnected treatments.
The findings point to how care is organized as an important factor, but the study does not say what changes will follow.
A study found that better-rated primary care was linked to a weaker association between multiple chronic illnesses and hospital stays among older people using Brazil’s public health system, the SUS.
In Brazil’s supplementary health system, the association went in the opposite direction.
The study analyzed data from 9,058 people aged 50 or older, with an average age of 66.
Researchers said the difference may reflect the SUS’s proactive, coordinated care model and the more fragmented structure of supplementary care.
The study was led by researchers at the University of São Paulo’s medical school and published in The Lancet Regional Health – Americas.
- Who
- Researchers led by a team at the University of São Paulo medical school studied people aged 50 and older in Brazil.
- What
- The study linked better-rated primary care to a weaker association between multimorbidity and hospital stays in the SUS, but found the opposite pattern in supplementary health care.
- When
- The data came from the 2019–2021 round of the Elsi-Brasil study. The article was published on November 9, 2026.
- Where
- Brazil, across the public SUS and the supplementary health system.
- Why
- Researchers pointed to differences in how the systems are organized: the SUS uses proactive teams responsible for a defined population, while supplementary care is more fragmented.
SUS
Supplementary health system
Care model
SUS
Primary care teams proactively coordinate care for a defined population, with targets and planned follow-up.
Supplementary health system
Direct access to specialists, tests and hospitals is more common, and primary care is less likely to coordinate care.
Study finding
SUS
Better-rated primary care was linked to a weaker association between multiple chronic illnesses and hospital stays.
Supplementary health system
Better-rated primary care was linked to a stronger association between multiple chronic illnesses and hospital stays.
Participants took part in this round of the Elsi-Brasil study, whose data were analyzed in the research.
Folha published its report on the study.
- Study sample
- 9,058 people aged 50 or older
- Average age
- 66 years
- Data period
- 2019–2021
- Multimorbidity definition
- At least 2 of 13 chronic diseases
- Prevalence in sample
- 38% reported multimorbidity
1 source
What people are saying
Primary care in the SUS is more proactive. It does not wait. It has targets to meet, care coordination, visits at predefined intervals.
The acute problem is only the tip of the iceberg.
The challenge is not to offer more and more procedures to people who have more and more diseases, but to build systems capable of caring for these people in an integrated way over time.