Bariatric Surgery Offer in Brazil: a Macroeconomic Analysis of the Health system’s Inequalities
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Brazil currently holds the second place in the worldwide ranking of the largest number of bariatric surgical procedures performed. The offer of bariatric surgery in the public health system is not sufficient for its demand; it remains to be determined whether the recent economic downturn affected this offer.
To analyze the proportion of bariatric surgeries performed by the public system in Brazil and assess the influence of macroeconomic variables over time.
This is a nationwide analysis which correlated the estimated number of bariatric surgeries in Brazil in both public and private health-providing systems from 2003 through 2017 with the main macroeconomic variables of Brazil during the evaluated period (gross domestic product [GDP], inflation rate, and unemployment rate), and both overall and public healthcare expenditures.
The proportion of surgeries performed in the public system varied from 7.1% in 2014 to 10.4% in 2004. There was a significant positive correlation between the public proportion of surgeries with the unemployment rate (R = 0.55666; P = 0.03868). There were significant negative correlations between the proportion of public surgeries with the public health expenditure per capita (R = − 0.88811; P = 0.00011) and with the public percentage of healthcare expenditure per capita (R = − 0.67133; P = 0.01683).
There were direct correlations between the number of public bariatric procedures and the unemployment rate, as well as with the public healthcare expenditure per capita. Despite the increase in the number of public procedures, its proportion reveals an insufficiency of the current offer of bariatric surgery provided by the public system.
KeywordsBariatric surgery Obesity Economics Socioeconomic factors Economic indexes
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
Statement of Human and Animal Rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 1.World Health Organization. Global status report on noncommunicable diseases 2014. Geneva: WHO; 2014. p. 1–298.Google Scholar
- 13.Malta DC, Bernal RTI, Andrade SSCA, et al. Prevalence of and factors associated with self-reported high blood pressure in Brazilian adults. Rev Saude Publica. 2017;51(suppl 1):11s.Google Scholar
- 14.Sociedade Brasileira de Cirurgia Bariátrica e Metabólica. Volume cirurgias bariátricas (por ano) [Bariatric surgery numbers (per year)]. Available from: [http://www.sbcb.org.br/wordpress/imprensa-2/releases/evolucao-das-cirurgias-bariatricas-no-brasil/]. Accessed September 10, 2018.
- 15.Ministério da Saúde, Brasil. Datasus: Informações de Saúde 2018 [Datasus: data on health 2018]. Available from: [http://www2.datasus.gov.br/DATASUS/index.php?area=0202&id=11633]. Accessed: September 10, 2018.
- 16.Brasil. Instituto de Pesquisa Econômica Aplicada (Ipea). Ipeadata. Macroeconomic. Most request series. [http://www.ipeadata.gov.br]. Accessed September 10, 2017.
- 17.World Health Organization. Global health expenditure database. [http://apps.who.int/nha/database/ViewData/Indicators/en]. Accessed September 10, 2018.
- 21.Agência Nacional de Saúde Suplementar, Brasil [National Agency for supplementary health, Brazil]. Dados gerais: Beneficiários de planos privados de saúde, por cobertura assistencial (Brasil - 2007-2017) [general data: beneficiaries of private health plans, by assistance coverage (Brazil, 2007-2017)]. [http://www.ans.gov.br/perfil-do-setor/dados-gerais]. Accessed: September 01, 2018.
- 23.Norte A, Sospedra I, Ortíz-Moncada R. Influence of economic crisis on dietary quality and obesity rates. Int J Food Sci Nutr. 2018:1–8. https://doi.org/10.1080/09637486.2018.
- 30.Ministério da Saúde, Brasil. Cinco fatos que você precisa saber sobre a cirurgia bariátrica no SUS [five facts you need to know about bariatric surgery in the public system]. [http://www.brasil.gov.br/noticias/saude/2016/05/cinco-fatos-que-voce-precisa-saber-sobre-a-cirurgia-bariatrica-no-sus]. Accessed: September 16, 2018.
- 31.Ministério da Saúde, Brasil [Department of Health, Brazil]. Portaria 425 [ordinance 425]. [http://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0425_19_03_2013.html]. Accessed: April 20, 2018.
- 32.Conselho Federal de Medicina, Brasil [Federal Council of Medicine, Brazil]. Resolução 2131/2015 [resolution 2131/2015]. [http://www.portalmedico.org.br/resolucoes/cfm/2015/2131_2015.pdf]. Accessed: September 09, 2018.
- 35.Scheffer M, Cassenote A, Guilloux AGA, et al. Demografia Médica no Brasil 2018 [Medical demography in Brazil 2018] Available from: [https://jornal.usp.br/wp-content/uploads/DemografiaMedica2018.pdf] Accessed: December 12, 2018.
- 36.Federação Brasileira de Hospitais. Cenário dos hospitais no Brasil 2018 [Scenery of hospitals in Brazil 2018]. Available from: [http://fbh.com.br/wp-content/uploads/2018/07/Relatorio-FBH-CNS_web.pdf]. Accessed: December 15, 2018.