Research Collaborator Program in Global Surgery and Social Change - Harvard Medical School. Postgraduate Program in Translational Surgery of Federal University of São Paulo, Brazil
Introduction: The COVID-19 pandemic impacted healthcare systems worldwide. In Brazil, it spread rapidly, catching the healthcare system off-guard and bringing significant challenges to the SUS (Sistema Único de Saúde). This study aim to assess the impact of the COVID-19 pandemic on the accessibility of neurosurgical-procedures in the SUS.
Methods: An analysis was conducted on 182 neurosurgical-procedures recorded in the Brazilian Hospital Information System within the DATASUS database. The data covered the period from January to March for the years 2020 to 2023. Linear-regression and paired t-test analyses were used, with statistical significance set at P< 0.05. Comparisons were made between the different time periods, using the data from 2020 as the baseline.
Results: The total number of identified procedures during the January-March period was 22,331 in 2020, 18,606 in 2021, 20,681 in 2022, and 22,913 in 2023. There was an overall decrease of 16.7% (3,705 cases) in all neurosurgical-procedures in 2021, followed by a recovery in procedure numbers in 2022 and 2023, with a decrease of 7.39% and an increase of 2.61%, respectively. The linear-regression analysis comparing the 4 time points did not demonstrate statistical significance, likely due to the limited number of periods assessed. However, the raw-data clearly showed a substantial reduction in procedure accessibility during the study periods. For brain-biopsies, the baseline was 83, with reductions of 30.1%, 25.3%, and 22.9% in 2021, 2022, and 2023, respectively. Surgeries for Syringomyelia and Chiari-I-malformation had a baseline of 37, with reductions of 51.35%, 24.32%, and 29.73% in 2021, 2022, and 2023, respectively. Surgical treatment of aneurysms had a baseline of 877, with decreases of 22.6%, 15.4%, and 15.3% in 2021, 2022, and 2023, respectively.
Conclusion : The COVID-19 pandemic substantially impacted access to neurosurgical-procedures in the Brazilian Public-Health-System, exacerbating existing challenges in meeting the population's demand for such treatments.
.jpg "Marcio Yuri Ferreira, MD photo")