Hospital burden of accidents involving venomous animals in Brazil from 2014 to 2023

Abstract Background Accidents caused by venomous animals represent a major neglected public health problem in tropical countries. However, the economic impact of these events on the Brazilian public health system remains insufficiently characterized. This study aimed to evaluate temporal trends, direct hospital costs, and the spatial distribution of hospitalizations due to venomous animal accidents in Brazil from 2014 to 2023. Methods An ecological study was conducted using data from the Hospital Information System of the Brazilian Unified Health System. Generalized linear models with quasi-Poisson and gamma distributions were applied to assess temporal trends and factors associated with hospital costs. Spatial analysis was performed to map expenditures across municipalities and states. Results A total of 186,367 hospitalizations were recorded, indicating a significant increasing trend over the study period. Total hospital costs reached 13.6 million United States dollars, with admissions to intensive care units accounting for 18.1% of total expenditures. Snakebites were responsible for the greatest financial impact, while scorpion stings showed the highest incidence. Regional analysis revealed marked disparities: the North region presented a high volume of hospitalizations with lower average costs, whereas the Southeast region concentrated most intensive care expenditures. Multivariable analysis showed that hospitalizations among older adults and those occurring in states such as Ceará and São Paulo were associated with significantly higher costs compared to the reference category. Conclusions Accidents caused by venomous animals impose a growing economic burden on the Brazilian public health system. Regional differences in costs likely reflect logistical barriers and delayed access to high-complexity care in the Amazon region rather than greater system efficiency. Public health policies should prioritize the decentralization of antivenom distribution in remote areas and the strengthening of toxicological care centers in urban settings.