Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPTRUCHE, Paul R.NAUS, Abbie E.BOTELHO, FabioFERREIRA, JuliaBOWDER, AlexisCADDELL, LukeZIMMERMAN, KathrinFARIA, Isabella Maria de FreitasLOPES, Bellisa CaldasCOSTA, Eduardo CorreaDANTAS, Fernanda Lage LimaCAVALCANTE, Augusto J. S. A.CARVALHO, Carlos A. L. B.ABIB, SimoneMOONEY, David P.ALONSO, Nivaldo2023-08-162023-08-162023WORLD JOURNAL OF PEDIATRIC SURGERY, v.6, n.3, article ID e000534, 11p, 2023https://observatorio.fm.usp.br/handle/OPI/54539ObjectiveIn this study, we assess the delivery of congenital pediatric surgical care under Brazil's system of universal health coverage and evaluate differences in delivery between public and private sectors. MethodsA cross-sectional national survey of pediatric surgeons in Brazil was conducted. Participants were asked which of 23 interventions identified through the Disease Control Priorities 3 (Surgical Interventions for Congenital Anomalies) they perform and to report barriers faced while providing surgical care. Responses were weighted by state and stratified by sector (public vs private). ResultsA sample of 352 responses was obtained and weighted to represent 1378 practicing pediatric surgeons registered in Brazil during the survey time. 73% spend the majority of their time working in the public sector ('Sistema unico de Saude' and Foundation hospitals), and most of them also work in the private sector. Generally, Brazilian pediatric surgeons have the expertise to provide thoracic, abdominal, and urologic procedures. Surgeons working mostly in the public sector were more likely to report a lack of access to essential medications (25% vs 9%, p<0.01) and a lack of access to hospital beds for surgical patients (52% vs 32%, p<0.01). ConclusionsBrazilian pediatric surgeons routinely perform thoracic, abdominal, and urologic surgery. Those working in government-financed hospitals face barriers related to infrastructure, which may impact Brazilians who rely on Brazil's universal health coverage system. Policies that support pediatric surgeons working in the public sector may promote the workforce available to provide congenital pediatric surgical care.engopenAccessCongenital AbnormalitiesPediatricsHealth Care Economics and OrganizationsHospitalsPediatricmiddle-income countriesglobal surgeryaccessarticleCopyright BMJ PUBLISHING GROUP10.1136/wjps-2022-000534PediatricsSurgery2516-5410