Sex difference in Parkinson's disease hospitalization rates in Brazil (2010-2024)

Sex-related differences in the epidemiology and outcomes of Parkinson's disease (PD) have been consistently reported. However, population-level evidence on disparities in hospitalization burden remains limited, particularly in low- and middle-income countries. This study aimed to assess sex-specific differences in hospitalization rates for PD in Brazil over a 15-year period.

Nationwide hospital admission data for Parkinson's disease were obtained from the Brazilian national hospital information system for the period 2010-2024. Resident population estimates were used to calculate hospitalization rates per 1,000,000 inhabitants for males and females. Descriptive analyses included mean rates and graphical distribution assessment. Both crude and age-standardized rates were calculated. Sex-specific differences were assessed using Wilcoxon signed-rank tests. Effect size was estimated using mean rate ratios (RR) with 95% confidence intervals. Durbin-Watson test was applied and Newey-West standard errors were used to obtain robust estimates. All analyses were conducted using Python 3.10.12.

A total of 17,108 hospitalizations for Parkinson's disease were analyzed, with an overall mean crude hospitalization rate of 5.58 per 1,000,000 inhabitants. Males consistently exhibited higher crude hospitalization rates than females (6.67 vs. 4.53 per 1,000,000 inhabitants). This difference was statistically significant (p < 0.001) and associated with a very large effect size (RR = 1.496; 95% CI: 1.387-1.605). The findings remained robust after correction for serial autocorrelation.

Hospitalization rates for Parkinson's disease are significantly higher among males than females in Brazil. The observed disparity was substantial and statistically robust across multiple analytical approaches. These findings highlight the importance of sex-sensitive healthcare strategies and targeted interventions to reduce preventable hospitalizations and optimize Parkinson's disease management.