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Non-cardiac surgery in developing countries: epidemiological aspects and economical opportunities--the case of Brazil.
Yu, Pai Ching; Calderaro, Daniela; Gualandro, Danielle Menosi; Marques, Andre Coelho; Pastana, Adriana Feio; Prandini, Joao Carlos; Caramelli, Bruno.
Afiliación
  • Yu PC; Interdisciplinary Medicine in Cardiology Unit, Heart Institute (InCor)-Hospital das Clínicas-University of São Paulo Medical School, São Paulo, Brazil.
PLoS One ; 5(5): e10607, 2010 May 12.
Article en En | MEDLINE | ID: mdl-20485549
BACKGROUND: Worldwide distribution of surgical interventions is unequal. Developed countries account for the majority of surgeries and information about non-cardiac operations in developing countries is scarce. The purpose of our study was to describe the epidemiological data of non-cardiac surgeries performed in Brazil in the last years. METHODS AND FINDINGS: This is a retrospective cohort study that investigated the time window from 1995 to 2007. We collected information from DATASUS, a national public health system database. The following variables were studied: number of surgeries, in-hospital expenses, blood transfusion related costs, length of stay and case fatality rates. The results were presented as sum, average and percentage. The trend analysis was performed by linear regression model. There were 32,659,513 non-cardiac surgeries performed in Brazil in thirteen years. An increment of 20.42% was observed in the number of surgeries in this period and nowadays nearly 3 million operations are performed annually. The cost of these procedures has increased tremendously in the last years. The increment of surgical cost was almost 200%. The total expenses related to surgical hospitalizations were more than $10 billion in all these years. The yearly cost of surgical procedures to public health system was more than $1.27 billion for all surgical hospitalizations, and in average, U$445.24 per surgical procedure. The total cost of blood transfusion was near $98 million in all years and annually approximately $10 million were spent in perioperative transfusion. The surgical mortality had an increment of 31.11% in the period. Actually, in 2007, the surgical mortality in Brazil was 1.77%. All the variables had a significant increment along the studied period: r square (r(2)) = 0.447 for the number of surgeries (P = 0.012), r(2) = 0.439 for in-hospital expenses (P = 0.014) and r(2) = 0.907 for surgical mortality (P = 0.0055). CONCLUSION: The volume of surgical procedures has increased substantially in Brazil through the past years. The expenditure related to these procedures and its mortality has also increased as the number of operations. Better planning of public health resource and strategies of investment are needed to supply the crescent demand of surgery in Brazil.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Operativos / Países en Desarrollo Tipo de estudio: Health_economic_evaluation / Observational_studies / Prognostic_studies Aspecto: Determinantes_sociais_saude Límite: Humans País/Región como asunto: America do sul / Brasil Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2010 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Operativos / Países en Desarrollo Tipo de estudio: Health_economic_evaluation / Observational_studies / Prognostic_studies Aspecto: Determinantes_sociais_saude Límite: Humans País/Región como asunto: America do sul / Brasil Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2010 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos