NATIONAL TRENDS IN HOSPITALIZATIONS, IN-HOSPITAL MORTALITY, AND HEALTHCARE UTILIZATION FOR HODGKIN LYMPHOMA IN BRAZIL: A NATIONWIDE ECOLOGICAL STUDY (2014–2025)
- 1Faculdade de Ciências Médica de São José dos Campos, HUMANITAS, São José dos Campos, SP, Brazil
Abstract
Background: Hodgkin lymphoma (HL) is a highly curable lymphoid malignancy; however, hospitalization remains common because of treatment-related toxicity, infectious complications, and advanced disease. Nationwide analyses may provide insights into healthcare utilization and trends in hospital outcomes. Aim: To evaluate temporal trends in hospitalizations, in-hospital mortality, healthcare utilization, and regional disparities among patients hospitalized for Hodgkin lymphoma in Brazil between 2014 and 2025. Methods: A nationwide retrospective ecological study was conducted using data from the Brazilian Unified Health System Hospital Information System (SIH/SUS-DATASUS). Hospitalizations were analyzed according to sex, age (<60 or ≥60 years), and geographic region. Outcomes included annual hospitalizations, in-hospital mortality, mortality rate, length of stay, and hospitalization expenditures. Results: Between 2014 and 2025, 203,608 hospitalizations for HL were recorded in Brazil. Annual admissions increased from 13,708 to 20,262, with a temporary decline during the COVID-19 pandemic (2020–2022). Young adults aged 15–29 years accounted for the largest proportion of admissions (44.1%), while men represented 58.9% of hospitalized patients. The Southeast concentrated most hospitalizations, followed by the Northeast and South. A total of 17,027 in-hospital deaths occurred during the study period. Although annual deaths increased modestly (1,316 to 1,584), the hospital mortality rate declined by 18.6%, suggesting improved hospital outcomes. Mortality remained approximately twice as high among patients aged ≥ 60 years and was consistently highest in the North, Northeast, and South. Hospital expenditures increased from 25 million in 2014 to 56 million in 2025, showing continuous growth except for a slight decrease from 2020 to 2022. Expenditures were highest for patients under 60 years of age, with men accounting for the largest share, and the greatest investment was in the Southeast, Northeast, and South. The average length of hospital stay per LH decreased between 2014 and 2025, from 8.4 to 7.4 days (an 11.9% reduction) with longer hospital stays observed in the North and Northeast. The shortest average was 7.1 days in 2021. Discussion: A favorable epidemiological paradox was observed, with an increase in hospitalizations and a decrease in the mortality rate and length of hospital stay, possibly related to early diagnosis and therapeutic advances, reflecting greater hospital investment. However, regional inequality persists due to higher mortality rate in the North, despite the lower number of hospitalizations and deaths. Men had more hospitalizations, deaths, and costs. Patients over 60 years of age had higher mortality and costs, reflecting clinical complexity. The COVID-19 pandemic caused fluctuations in hospitalizations, length of stay, and costs, consistent with the reorganization of health services and temporary postponements, with recovery expected after 2022. Conclusion: Hospitalizations for Hodgkin lymphoma increased steadily in Brazil over the study period, accompanied by declining in-hospital mortality rates and shorter hospital stays, suggesting meaningful improvements in hospital care. Nevertheless, persistent regional disparities and poorer outcomes among older adults highlight the need to expand equitable access to specialized hematologic services and optimize care delivery across the country. This study received no financial support.
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BibTeX
@article{radtke2026national,
title = {{NATIONAL TRENDS IN HOSPITALIZATIONS, IN-HOSPITAL MORTALITY, AND HEALTHCARE UTILIZATION FOR HODGKIN LYMPHOMA IN BRAZIL: A NATIONWIDE ECOLOGICAL STUDY (2014–2025)}},
author = {Laysa Andrade RADTKE and Felipe Andreani Camargo MANDUCO and Fernando CALLERA},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.107709},
url = {https://doi.org/10.1016/j.htct.2026.107709},
note = {CC BY},
}
RIS
TY - JOUR
TI - NATIONAL TRENDS IN HOSPITALIZATIONS, IN-HOSPITAL MORTALITY, AND HEALTHCARE UTILIZATION FOR HODGKIN LYMPHOMA IN BRAZIL: A NATIONWIDE ECOLOGICAL STUDY (2014–2025)
AU - Laysa Andrade RADTKE
AU - Felipe Andreani Camargo MANDUCO
AU - Fernando CALLERA
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.107709
UR - https://doi.org/10.1016/j.htct.2026.107709
AB - Background: Hodgkin lymphoma (HL) is a highly curable lymphoid malignancy; however, hospitalization remains common because of treatment-related toxicity, infectious complications, and advanced disease. Nationwide analyses may provide insights into healthcare utilization and trends in hospital outcomes. Aim: To evaluate temporal trends in hospitalizations, in-hospital mortality, healthcare utilization, and regional disparities among patients hospitalized for Hodgkin lymphoma in Brazil between 2014 and 2025. Methods: A nationwide retrospective ecological study was conducted using data from the Brazilian Unified Health System Hospital Information System (SIH/SUS-DATASUS). Hospitalizations were analyzed according to sex, age (<60 or ≥60 years), and geographic region. Outcomes included annual hospitalizations, in-hospital mortality, mortality rate, length of stay, and hospitalization expenditures. Results: Between 2014 and 2025, 203,608 hospitalizations for HL were recorded in Brazil. Annual admissions increased from 13,708 to 20,262, with a temporary decline during the COVID-19 pandemic (2020–2022). Young adults aged 15–29 years accounted for the largest proportion of admissions (44.1%), while men represented 58.9% of hospitalized patients. The Southeast concentrated most hospitalizations, followed by the Northeast and South. A total of 17,027 in-hospital deaths occurred during the study period. Although annual deaths increased modestly (1,316 to 1,584), the hospital mortality rate declined by 18.6%, suggesting improved hospital outcomes. Mortality remained approximately twice as high among patients aged ≥ 60 years and was consistently highest in the North, Northeast, and South. Hospital expenditures increased from 25 million in 2014 to 56 million in 2025, showing continuous growth except for a slight decrease from 2020 to 2022. Expenditures were highest for patients under 60 years of age, with men accounting for the largest share, and the greatest investment was in the Southeast, Northeast, and South. The average length of hospital stay per LH decreased between 2014 and 2025, from 8.4 to 7.4 days (an 11.9% reduction) with longer hospital stays observed in the North and Northeast. The shortest average was 7.1 days in 2021. Discussion: A favorable epidemiological paradox was observed, with an increase in hospitalizations and a decrease in the mortality rate and length of hospital stay, possibly related to early diagnosis and therapeutic advances, reflecting greater hospital investment. However, regional inequality persists due to higher mortality rate in the North, despite the lower number of hospitalizations and deaths. Men had more hospitalizations, deaths, and costs. Patients over 60 years of age had higher mortality and costs, reflecting clinical complexity. The COVID-19 pandemic caused fluctuations in hospitalizations, length of stay, and costs, consistent with the reorganization of health services and temporary postponements, with recovery expected after 2022. Conclusion: Hospitalizations for Hodgkin lymphoma increased steadily in Brazil over the study period, accompanied by declining in-hospital mortality rates and shorter hospital stays, suggesting meaningful improvements in hospital care. Nevertheless, persistent regional disparities and poorer outcomes among older adults highlight the need to expand equitable access to specialized hematologic services and optimize care delivery across the country. This study received no financial support.
SN - 2531-1379
SN - 2531-1387
ER -