Early characterization of an adult population at an insurer’s point of entry as an opportunity to identify hospitalization risk ; Caracterización temprana de población adulta al ingreso de una aseguradora como oportunidad para identificar el riesgo de hospitalización ; Caracterização precoce da população adulta no momento da admissão em uma seguradora como oportunidade para identificar o risco de internação

Highlights Patients’ characterization at insurers’ point of entry allows the generation of specific profiles to guide risk management programs. Predicting hospitalization risk enables timely action to minimize costs and catastrophic health events. Identifying the risks of an insurer's members is essential for managing them in a timely manner from the moment of enrollment. It is important to implement predictive programs when providing healthcare services. Introduction: Health Benefit Plan Administrators must manage the health risk of their members. Therefore, health characterization is performed from enrollment to support decision-making and timely intervention. Objective: To analyze the historical results of characterizing the adult population on admission to the insurance company in relation to the demand for all-cause and psychiatric hospitalization services. Materials and Methods: An observational cross-sectional study with members over 18 years of age, in which an analysis was made of the characterization of the adult population of the insurer and its association with the use of medical consultation services in primary care and all-cause and psychiatric hospitalizations. Bivariate and multivariate analysis was made, and odds ratios (OR) were calculated in logistic regression. Results: Variables significantly associated with having an all-cause hospitalization were identified: having referred history of heart disease OR=1.71(95%CI: 1.33; 2.20), respiratory disease OR= 1. 30(95%CI: 1.04; 1.61), chronic kidney disease OR=1.66(95%CI: 1.13; 2.45), cancer OR=1.65(95%CI: 1.14; 2.40), taking any medication permanently OR=1.35(95%CI: 1.174; 1.56) and smoking OR=1.44(95%CI: 1.12; 1.85). For psychiatric hospitalizations, a history of discouragement, depression, or little hope was relevant with OR=5.12(95%CI: 1.89; 13.87). Discussion: The characterization of patients during enrolment allowed the identification of predictor variables of hospitalization, guiding management from the primary care level minimizing costs and ...