Bariatric surgeries performed by the Brazilian National Health System in the period 2010-2016: a descriptive study of hospitalizations

Carvalho, Adriane da Silva; Rosa, Roger dos Santos

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 28 (1) • 2019 • https://doi.org/10.5123/S1679-49742019000100023 copy

Bariatric surgeries performed by the Brazilian National Health System in the period 2010-2016: a descriptive study of hospitalizations^* * Article derived from the Master’s Degree thesis entitled ‘Bariatric surgery performed by the National Health System - 2010-2016: an analysis of hospitalizations, defended by Adriane da Silva Carvalho at the Public Health Postgraduate Program of the Federal University of Rio Grande do Sul (UFRGS) in 2018.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to characterize Brazilian National Health System (SUS) hospitalizations for bariatric surgeries in Brazil, in the period 2010-2016.

Methods:

this was a descriptive study of time series using data from the SUS Hospital Information System (SIH/SUS); the target population consisted of patients aged 16 years and older.

Results:

there were 46,035 hospitalizations (6,576/year; 4.3/100,000 inhabitants/year); average age was 39.0 years old (SD:10.4); female sex predominated (85.4%), and the 35-39 age group accounted for 18.0% of cases; 16,923 patients (36.8%) needed to be admitted to the intensive care unit (ICU); there were 99 (0.2%) in-hospital deaths; the median hospital stay was 3 days, and the interquartile range was 2 days; average annual expense was R$ 39,410,919.37 and the average cost of hospitalization was R$ 5,992.75 (R$ 1,464.15/day).

Conclusion:

bariatric surgeries were characterized as procedures involving young female adults, frequent ICU use and low lethality.

Keywords:
Obesity; Bariatric Surgery; Hospitalization; Brazilian National Health System; Time Series Studies

Region	Males						Females						Total
Region	16-29	Rate	30-49	Rate	50+	Rate	16-29	Rate	30-49	Rate	50+	Rate	Total
Without ICU
North	12	0.1	41	0.3	6	0.1	52	0.3	171	1.1	35	0.4	317
Northeast	95	0.2	267	0.5	69	0.2	347	0.7	1,240	2.2	300	0.8	2,318
Midwest	35	0.2	56	0.4	11	0.1	123	0.9	367	2.3	74	0.7	666
Southeast	381	0.5	1,159	1.3	322	0.5	1,825	2.6	7,524	8.4	2,113	2.8	13,324
South	303	1.2	692	2.4	211	0.9	2,477	10.1	7,042	23.8	1,762	6.7	12,487
Total	826	0.5	2,215	1.1	619	0.5	4,824	2.7	16,344	7.9	4,284	2.7	29,112
With ICU
North	7	-	23	0.1	7	0.1	31	0.2	124	0.8	25	0.3	217
Northeast	55	0.1	177	0.3	35	0.1	191	0.4	638	1.1	181	0.5	1,277
Midwest	12	0.1	16	0.1	10	0.1	16	0.1	46	0.3	14	0.1	114
Southeast	137	0.2	419	0.5	171	0.3	415	0.6	1,701	1.9	751	1.0	3,594
South	506	2.0	1,156	3.9	337	1.5	2,067	8.4	5,812	19.6	1,843	7.0	11,721
Total	717	0.4	1,791	0.9	560	0.4	2,720	1.5	8,321	4.0	2,814	1.8	16,923

Period	Gastroplasty with intestinal bypass		Gastrectomy with or without duodenal switch		Vertical gastrectomy (sleeve gastrectomy)		Vertical banded gastroplasty		Total
Period	n	%	n	%	n	%	n	%	N
2010	4,251	94.7	47	1.0	-	-	189	4.2	4,487
2011	5,026	93.6	143	2.7	-	-	201	3.7	5,370
2012	5,749	95.4	25	0.4	-	-	253	4.2	6,027
2013	6,470	95.1	31	0.5	148	2.2	151	2.2	6,800
2014	6,591	93.8	22	0.3	340	4.8	71	1	7,024
2015	6,880	91.4	34	0.5	549	7.3	68	0.9	7,531
2016	8,403	95.5	16	0.2	314	3.6	63	0.7	8,796
Total	43,370	94.2	318	0.7	1,351	2.9	996	2.2	46,035

Period	North		Northeast		Midwest		Southeast		South		Brazil
Period	n	%	n	%	n	%	n	%	n	%	N	Rate (per 100,000 inhab.)
2003	58	3.3	208	11.7	158	8.9	812	45.7	542	30.5	1,778	1.0
2004	50	2.7	182	9.7	112	6.0	940	50.2	588	31.4	1,872	1.0
2005	66	2.9	285	12.6	131	5.8	944	41.7	840	37.1	2,266	1.2
2006	81	3.2	260	10.3	167	6.6	1,200	47.5	820	32.4	2,528	1.3
2007	105	3.5	253	8.5	146	4.9	1,379	46.3	1,095	36.8	2,978	1.6
2008	50	1.6	375	11.7	132	4.1	1,245	39.0	1,393	43.6	3,195	1.7
2009	62	1.7	437	11.7	176	4.7	1,284	34.4	1,772	47.5	3,731	1.9
Total^c	472	2.6	2,000	10.9	1,022	5.6	7,804	42.5	7,050	38.4	18,348
2010	40	0.9	413	9.2	161	3.6	1,496	33.3	2,377	53.0	4,487	2.3
2011	62	1.2	487	9.1	109	2.0	1,848	34.4	2,864	53.3	5,370	2.7
2012	91	1.5	583	9.7	82	1.4	2,111	35.0	3,160	52.4	6,027	3.0
2013	98	1.4	542	8.0	100	1.5	2,412	35.5	3,648	53.6	6,800	3.4
2014	63	0.9	487	6.9	122	1.7	2,639	37.6	3,713	52.9	7,024	3.5
2015	106	1.4	490	6.5	152	2.0	2,771	36.8	4,012	53.3	7,531	3.7
2016	65	0.7	585	6.7	42	0.5	3,192	36.3	4,912	55.8	8,796	4.3
Total^d	525	1.1	3,587	7.8	768	1.7	16,469	35.8	24,686	53.6	46,035
Total^e	997	1.5	5,587	8.7	1,790	2.8	24,273	37.7	31,736	49.3	64,383

Period	Region
	North		Northeast		Midwest		Southeast		South		Total
	Deaths (n)	Lethality (%)	Deaths (n)	Lethality (%)	Deaths (n)	Lethality (%)	Deaths (n)	Lethality (%)	Deaths (n)	Lethality (%)	Deaths (n)	Lethality (%)
2003	1	1.7	-	-	4	2.5	3	0.4	3	0.6	11	0.6
2004	-	-	-	-	3	2.7	7	0.7	7	1.2	17	0.9
2005	1	1.5	1	0.4	1	0.8	4	0.4	5	0.6	12	0.5
2006	-	-	1	0.4	-	-	5	0.4	11	1.3	17	0.7
2007	-	-	-	-	3	2.1	9	0.7	11	1.0	23	0.8
2008	1	2.0	2	0.5	-	-	2	0.2	10	0.7	15	0.5
2009	-	-	-	-	1	0.6	3	0.2	7	0.4	11	0.3
Total^c	3	0.6	4	0.2	12	1.2	33	0.4	54	0.8	106	0.6
2010	1	2.5	-	-	2	1.2	6	0.4	8	0.3	17	0.4
2011	-	-	-	-	-	-	5	0.3	6	0.2	11	0.2
2012	-	-	-	-	-	-	6	0.3	5	0.2	11	0.2
2013	1	1.0	-	-	2	2.0	7	0.3	4	0.1	14	0.2
2014	-	-	-	-	-	-	6	0.2	9	0.2	15	0.2
2015	1	0.9	-	-	2	1.3	3	0.1	5	0.1	11	0.1
2016	-	-	1	0.2	1	2.4	9	0.3	9	0.2	20	0.2
Total^d	3	4.5	1	0	7	6.9	42	0.3	46	0.2	99	0.2
Total^e	6	0.6	5	0.1	19	1.1	75	0.3	100	0.3	205	0.3

Period	n	Average cost per hospitalization (BRL)	Total cost (BRL)	Total cost (Int$)
2003	1,778	3,211.30	5,709,691.40	5,876,915.27
2004	1,872	3,229.16	6,044,987.52	5,933,425.99
2005	2,266	3,272.35	7,415,145.10	6,992,449.10
2006	2,528	3,220.60	8,141,676.80	7,411,039.24
2007	2,978	3,448.65	10,270,079.70	9,015,837.53
2008	3,195	4,925.31	15,736,365.45	12,948,406.31
2009	3,731	5,446.52	20,320,966.12	15,699,572.73
Total ^c	18,348	4,241.24	77,818,248.23	63,877,646.17
2010	4,487	5,468.28	24,536,171.50	17,699,232.84
2011	5,370	5,450.78	29,270,675.02	19,897,474.92
2012	6,027	5,431.91	32,738,091.85	20,999,143.20
2013	6,800	6,028.74	40,995,428.31	24,856,369.98
2014	7,024	6,340.68	44,536,960.52	25,489,387.10
2015	7,531	6,321.10	47,604,227.05	25,602,056.98
2016	8,796	6,388.69	56,194,881.41	28,302,695.20
Total^d	46,035	5,992.75	275,876,435.56	162,846,360.22
Total^e	64,383	5,493.60	353,694,683.79	226,724,006.39

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Adriane da Silva Carvalho - Rua Vicente da Fontoura, No. 2005, Apto. 306, Rio Branco, Porto Alegre, RS, Brazil. Postcode: 90640-003. E-mail: adrianedasc@hotmail.com