Geographical Inequalities in Access to Bellwether Procedures in Brazil

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFALEIRO, Matheus Daniel
dc.contributor.authorFERNANDEZ, Miguel Godeiro
dc.contributor.authorSANTOS, Jessica Moreira
dc.contributor.authorMENEZES, Catarina Ester Gomes
dc.contributor.authorLIMA, Joao Vitor Sabadine
dc.contributor.authorHADDAD, Julia Oliveira Dabien
dc.contributor.authorVIANA, Sofia Wagemaker
dc.contributor.authorALONSO, Nivaldo
dc.date.accessioned2023-08-16T17:44:16Z
dc.date.available2023-08-16T17:44:16Z
dc.date.issued2023
dc.description.abstractBackground Brazil is a middle-income country that aims to provide universal health coverage, but its surgical system's efficiency has rarely been analyzed. In an effort to strengthen surgical national systems, the Lancet Commission on Global Surgery proposed bellwether procedures as quality indicators of surgical workforces. This study aims to evaluate regional inequalities in access to bellwether procedures and their associated mortality across the five Brazilian geographical regions.Methods Using DATASUS, Brazil's national healthcare database, data were collected on the total amount of performed bellwether procedures-cesarean section, laparotomy, and open fracture management-and their associated mortality, by geographical region. We evaluated the years 2018-2020, both in emergent and elective conditions. Statistical analysis was performed by one-way ANOVA test and Tukey's multiple comparisons test.Results During this period, DATASUS registered 2,687,179 cesarean sections, 1,036,841 laparotomies, and 648,961 open fracture treatments. The access and associated mortality related to these procedures were homogeneous between the regions in elective care. There were significant geographical inequalities in access and associated mortality in emergency care (p < 0.05, 95% CI) for all bellwether procedures. The Southeast, the most economically developed region of the country, was the region with the lowest amount of bellwether procedures per 100,000 inhabitants.Conclusion Brazil's public surgical system is competent at promoting elective surgical care, but more effort is needed to fortify emergency care services. Public policies should encourage equity in the geographic allocation of the surgical workforce.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationWORLD JOURNAL OF SURGERY, v.47, n.3, p.593-599, 2023
dc.identifier.doi10.1007/s00268-022-06855-9
dc.identifier.eissn1432-2323
dc.identifier.issn0364-2313
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/54535
dc.language.isoeng
dc.publisherSPRINGEReng
dc.relation.ispartofWorld Journal of Surgery
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright SPRINGEReng
dc.subject.othersurgical careeng
dc.subject.othermanagementeng
dc.subject.wosSurgeryeng
dc.titleGeographical Inequalities in Access to Bellwether Procedures in Brazileng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryRússia
hcfmusp.affiliation.countryisoru
hcfmusp.author.externalFALEIRO, Matheus Daniel:Univ Fed Minas Gerais, Belo Horizonte, Brazil; Int Student Surg Network Brazil, Belo Horizonte, Brazil
hcfmusp.author.externalFERNANDEZ, Miguel Godeiro:Int Student Surg Network Brazil, Belo Horizonte, Brazil; Bahiana Sch Med & Publ Hlth EBMSP, Salvador, Brazil
hcfmusp.author.externalSANTOS, Jessica Moreira:Int Student Surg Network Brazil, Belo Horizonte, Brazil; Fac Ciencias Med Minas Gerais, Belo Horizonte, Brazil
hcfmusp.author.externalMENEZES, Catarina Ester Gomes:Int Student Surg Network Brazil, Belo Horizonte, Brazil; Univ Estado Bahia, Salvador, Brazil
hcfmusp.author.externalLIMA, Joao Vitor Sabadine:Univ Fed Minas Gerais, Belo Horizonte, Brazil; Int Student Surg Network Brazil, Belo Horizonte, Brazil
hcfmusp.author.externalHADDAD, Julia Oliveira Dabien:Int Student Surg Network Brazil, Belo Horizonte, Brazil; Univ Itauna, Itauna, Brazil
hcfmusp.author.externalVIANA, Sofia Wagemaker:Int Student Surg Network Brazil, Belo Horizonte, Brazil; Kursk State Med Univ, Kursk, Russia
hcfmusp.citation.scopus2
hcfmusp.contributor.author-fmusphcNIVALDO ALONSO
hcfmusp.description.beginpage593
hcfmusp.description.endpage599
hcfmusp.description.issue3
hcfmusp.description.volume47
hcfmusp.origemWOS
hcfmusp.origem.pubmed36456731
hcfmusp.origem.scopus2-s2.0-85143238113
hcfmusp.origem.wosWOS:000912663500001
hcfmusp.publisher.cityNEW YORKeng
hcfmusp.publisher.countryUNITED STATESeng
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Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - HC/ICHC
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