Inequalities in laparoscopic surgery in the brazilian health system
1
Politics, Management and Health, School of Public Health/University of São Paulo, São Paulo, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1847
ABSTRACT
BACKGROUND:
Laparoscopic procedures are characterized as few abdominal incisions that, in the aftermath, improve patient’s postoperative performance through less complications and inpatient care. In Brazil, there is an important gap between laparotomy and laparoscopic surgeries on the public system¹, thus this study aims to identify the inequalities in laparoscopic surgery and the installed capacity of these equipments nationwide. Methodologies A secondary data quantitative study was conducted with data from Brazilian’s public health sector in 2024. All procedures officially classified in the system’s fee schedule lists as laparoscopic were selected and compared to the laparotomy respective one. A linkage between databases was conducted to connect the hospital’s information on its capabilities of producing laparoscopic procedures and the procedures itself. Through these processes, it was analyzed the installed capacity of these hospitals and Lost Opportunity Index (LOI), which represents the percentage of laparotomy procedures that were produced on a certified videolaparoscopic service.
RESULTS:
Were identified 627.099 procedures in 2024 eligible for this analysis and 3.478 health equipments were certified to have videolaparoscopic equipment, even though most of them are restricted to South, Southeast and Northeast of the country. Laparoscopic cholecystectomy appears as the number one procedure between all analyzed, with 182.338 surgeries conducted in Brazil. Average Length of Stay was shown to be reduced in laparoscopic procedures, in accordance with the literature¹⁻². As for the LOI, almost all procedures had a 50% plus rate.
CONCLUSIONS:
The data presented reflects the regional inequalities to guarantee access and quality in the healthcare system³⁻⁵. Even though laparoscopic surgeries are shown, in most cases, to improve patient outcomes and total cost to the system, there are other factors, such as medical training, installed capacity, service distribution and market logic, that needs to be considered to improve care to patients and in policies that tackle this problem.
Laparoscopic procedures are characterized as few abdominal incisions that, in the aftermath, improve patient’s postoperative performance through less complications and inpatient care. In Brazil, there is an important gap between laparotomy and laparoscopic surgeries on the public system¹, thus this study aims to identify the inequalities in laparoscopic surgery and the installed capacity of these equipments nationwide. Methodologies A secondary data quantitative study was conducted with data from Brazilian’s public health sector in 2024. All procedures officially classified in the system’s fee schedule lists as laparoscopic were selected and compared to the laparotomy respective one. A linkage between databases was conducted to connect the hospital’s information on its capabilities of producing laparoscopic procedures and the procedures itself. Through these processes, it was analyzed the installed capacity of these hospitals and Lost Opportunity Index (LOI), which represents the percentage of laparotomy procedures that were produced on a certified videolaparoscopic service.
RESULTS:
Were identified 627.099 procedures in 2024 eligible for this analysis and 3.478 health equipments were certified to have videolaparoscopic equipment, even though most of them are restricted to South, Southeast and Northeast of the country. Laparoscopic cholecystectomy appears as the number one procedure between all analyzed, with 182.338 surgeries conducted in Brazil. Average Length of Stay was shown to be reduced in laparoscopic procedures, in accordance with the literature¹⁻². As for the LOI, almost all procedures had a 50% plus rate.
CONCLUSIONS:
The data presented reflects the regional inequalities to guarantee access and quality in the healthcare system³⁻⁵. Even though laparoscopic surgeries are shown, in most cases, to improve patient outcomes and total cost to the system, there are other factors, such as medical training, installed capacity, service distribution and market logic, that needs to be considered to improve care to patients and in policies that tackle this problem.
| eISSN: | 2654-1459 |
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