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: In Brazil, the COVID-19 pandemic 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 response of the Brazilian Health System to 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 procedures in 2021, followed by a recovery in 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 demonstrated a significant decrease followed by a subsequent increase in the number of procedures performed. Furthermore, the mortality rate in 2020 was 8.22%, in 2021 9.62%, in 2022 8.77%, and in 2023 7.07%. The total number of surgeries and the mortality-rate displayed their worst numbers in 2021, coinciding with the peak of the pandemic in Brazil (March-2021). However, the Healthcare-System responded positively in the post-pandemic period, with an increase in the number of procedures and a considerable decrease in the mortality-rate.
Conclusion : The neurosurgical-related scenario in the Brazilian-Public-Health-System showed a recovery in both the number of procedures and the mortality-rate.