Cazzo Everton, Ramos Almino Cardoso, Chaim Elinton Adami
Department of Surgery; Faculty of Medical Sciences, State University of Campinas (UNICAMP), R. Alexander Fleming, s/n; Cidade Universitaria Zeferino Vaz, Campinas, SP, CEP 13085-000, Brazil.
Obes Surg. 2019 Jun;29(6):1874-1880. doi: 10.1007/s11695-019-03761-3.
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.
巴西目前在全球实施减肥手术数量排名中位居第二。公共卫生系统中减肥手术的供应不足以满足需求；近期的经济衰退是否影响了这一供应仍有待确定。
分析巴西公共系统实施减肥手术的比例，并评估宏观经济变量随时间的影响。
这是一项全国性分析，将2003年至2017年巴西公共和私人医疗系统中减肥手术的估计数量与评估期间巴西的主要宏观经济变量（国内生产总值[GDP]、通货膨胀率和失业率）以及总体和公共医疗支出相关联。
公共系统实施手术的比例从2014年的7.1%到2004年的10.4%不等。手术的公共比例与失业率之间存在显著正相关（R = 0.55666；P = 0.03868）。公共手术比例与人均公共卫生支出（R = - 0.88811；P = 0.00011）以及人均医疗支出的公共百分比（R = - 0.67133；P = 0.01683）之间存在显著负相关。
公共减肥手术数量与失业率以及人均公共医疗支出之间存在直接关联。尽管公共手术数量有所增加，但其比例显示出公共系统目前提供的减肥手术供应不足。
