Abstract
Background
The effect of nationwide economic issues on the necessary expansion in the number of bariatric procedures remains unclear.
Objective
This study aims to determine whether there are correlations between the growth rate in the number of bariatric surgeries and the major macroeconomic variables over time in Brazil.
Methods
It is a nationwide analysis regarding the number of bariatric surgeries in Brazil and the main national macroeconomic variables from 2003 through 2016: gross domestic product (GDP), inflation rate, and the unemployment rate, as well as the evolution in the number of registered bariatric surgeons.
Results
There were significant positive correlations of the growth rate of surgeries with the early variations of the GDP (R = 0.5558; p = 0.04863) and of the overall health expenditure per capita (R = 0.78322; p = 0.00259). The growth rate of the number of bariatric surgeries was not correlated with the unemployment and inflation rates, as well as with the growth rate of available bariatric surgeons.
Conclusion
There were direct relationships between the growth rate of bariatric surgeries and the evolutions of the GDP and health care expenditure per capita. These variables appear to influence the nationwide offer of bariatric surgery.
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References
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery and endoluminal procedures: IFSO Worldwide Survey 2014. Obes Surg. 2017;27(9):2279–89.
Ponce J, Nguyen NT, Hutter M, et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011–2014. Surg Obes Relat Dis. 2015;11(6):1199–200.
Ponce J, DeMaria EJ, Nguyen NT, et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in 2015 and surgeon workforce in the United States. Surg Obes Relat Dis. 2016;12(9):1637–9.
Ramos AC. Brazil looking for completing his space in bariatric surgery. Arq Bras Cir Dig. 2014;27(Suppl 1):1.
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.
Watts J. Brazil’s health system woes worsen in economic crisis. Lancet. 2016;387(10028):1603–4.
Barbosa-Filho FH. A crise econômica de 2014/2017 [the economic crisis of 2014/2017]. Estud Av. 2017;31(89):51–60.
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 12 Mar 2018.
Borisenko O, Adam D, Funch-Jensen P, et al. Bariatric surgery can lead to net cost savings to health care systems: results from a comprehensive European decision analytic model. Obes Surg. 2015;25(9):1559–68.
Klein S, Ghosh A, Cremieux PY, et al. Economic impact of the clinical benefits of bariatric surgery in diabetes patients with BMI ≥35 kg/m2. Obesity (Silver Spring). 2011;19(3):581–7.
Sociedade Brasileira de Cirurgia Bariátrica e Metabólica. Volume cirurgias bariátricas (por ano). Available from: http://www.sbcb.org.br/wordpress/imprensa-2/releases/evolucao-das-cirurgias-bariatricas-no-brasil/. Accessed 10 Dec 2017.
Brasil. Instituto de Pesquisa Econômica Aplicada (Ipea). Ipeadata. Macroeconomic. Most request series. Available from: http://www.ipeadata.gov.br/. Accessed 10 Dec 2017.
World Health Organization. Global health expenditure database. http://apps.who.int/nha/database/ViewData/Indicators/en. Accessed 25 Feb 2018.
World Health Organization. Global status report on noncommunicable diseases 2014. Geneva: WHO; 2014. p. 1–298.
Chaim EA, Pareja JC, Gestic MA, et al. Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System. Arq Gastroenterol. 2017;54(1):70–4.
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 20 Mar 2018.
Borges NB, Ferraz MB, Chacra AR. The cost of type 2 diabetes in Brazil: evaluation of a diabetes care center in the city of São Paulo, Brazil. Diabetol Metab Syndr. 2014;6(1):122.
Kelles SM, Machado CJ, Barreto SM. Ten-years of bariatric surgery in Brazil: in-hospital mortality rates for patients assisted by universal health system or a health maintenance organization. Arq Bras Cir Dig. 2014;27(4):261–7.
Palli S, Heidrich N. The short- and long-term economic impact of bariatric surgery coverage for a payer. Surg Obes Relat Dis. 2017;10(Suppl 1):S105.
Fujihara N, Lark ME, Fujihara Y, et al. The effect of economic downturn on the volume of surgical procedures: a systematic review. Int J Surg. 2017;44:56–63. https://doi.org/10.1016/j.ijsu.2017.06.036.
Bernstein DN, Brodell D, Li Y, et al. Impact of the economic downturn on elective lumbar spine surgery in the United States: a national trend analysis, 2003 to 2013. Global Spine J. 2017;7(3):213–9. https://doi.org/10.1177/2192568217694151.
Nguyen NT, Paya M, Stevens CM, et al. The relationship between hospital volume and outcome in bariatric surgery at academic medical centers. Ann Surg. 2004;240(4):586–93.
Jacobsen HJ, Bergland A, Raeder J, et al. High-volume bariatric surgery in a single center: safety, quality, cost-efficacy and teaching aspects in 2,000 consecutive cases. Obes Surg. 2012;22(1):158–66.
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 15 Mar 2018.
Conselho Federal de Medicina, Brasil [Federal Council of Medicine, Brazil]. Resolução 2172/2017 [Resolution 2172/2017]. https://www.poderesaude.com.br/novosite/images/Publica%C3%A7%C3%A3o_3_-_27.12.2017.pdf. Accessed 03 May 2018.
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Cazzo, E., Ramos, A.C., Pareja, J.C. et al. Nationwide Macroeconomic Variables and the Growth Rate of Bariatric Surgeries in Brazil. OBES SURG 28, 3193–3198 (2018). https://doi.org/10.1007/s11695-018-3318-5
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DOI: https://doi.org/10.1007/s11695-018-3318-5