Bariatric Surgery Offer in Brazil: a Macroeconomic Analysis of the Health system’s Inequalities

  • Everton CazzoEmail author
  • Almino Cardoso Ramos
  • Elinton Adami Chaim
Original Contributions



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.


Bariatric 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

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.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Surgery; Faculty of Medical SciencesState University of Campinas (UNICAMP)CampinasBrazil

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