Epidemiological Vulnerability and Hospital Readmissions Among the Maxakali Indigenous Population: A Longitudinal...

This study aims to analyze the epidemiological profile of hospitalizations among the Maxakali Indigenous population and characterize hospital readmission patterns using administrative hospital records from the Cura D'Ars Hospital, Minas Gerais, Brazil, between 2019 and 2025, with a detailed analysis of hospitalizations occurring in 2025. This retrospective observational study was based on an epidemiological audit of administrative hospital records extracted from the SPDATA Hospital Information System. Records were standardized and linked using an onomastic identification strategy combined with the National Health Card (CNS), enabling the identification of the Maxakali population, reconstruction of individual hospitalization histories, and characterization of readmissions. Descriptive analyses included hospitalization causes, length of stay, temporal distribution, and readmission patterns. A total of 364 hospitalizations occurring in 2025 were analyzed within a seven-year historical series. Infectious and respiratory diseases accounted for 73.7% of hospital admissions. The most frequent causes included infectious diseases, pneumonia/influenza, streptococcal infections, acute respiratory infections, and malnutrition. The readmission rate reached 40.1%, with infants presenting significantly higher odds of readmission (OR = 2.8; 95% CI: 1.9-4.1; p < 0.001). Mean hospital stay was 4.2 days and was significantly longer among children (p < 0.05). Temporal analysis revealed a reduction in hospitalizations during the COVID-19 pandemic followed by recovery in subsequent years, as well as seasonal peaks during the dry season. The Maxakali population presented a high burden of infectious and respiratory hospitalizations, elevated readmission rates, and concentration of admissions during early childhood, characterizing substantial epidemiological vulnerability. These findings reinforce the need to strengthen primary healthcare, improve post-discharge follow-up, expand immunization and sanitation initiatives, and implement culturally appropriate territorial healthcare strategies aimed at reducing potentially avoidable hospitalizations.