Abstract
To describe the number of funds made by the Brazilian National Health System to normal delivery and cesarean procedures, according to the Brazilian regions in 2015, and estimate the cost cutting if the recommendation concerning the prevalence of cesarean deliveries by the World Health Organization (10 to 15%) were respected. Secondary analysis of data from the Hospital Information System of the Brazilian National Health System. The variables considered were the type of delivery (cesarean section and normal), geographic region of admission, length of stay and amount paid for admission in 2015. In the year 2015, there were 984,307 admissions to perform labor in the five Brazilian regions, of which 36.2% were cesarean section. The Northeast and Southeast regions were the two regions that had the highest number of normal deliveries and cesarean sections. The overall average hospital stay for delivery was 3.2 days. About R$ 650 million (US$ 208,5 million) were paid, 45% of the total in cesarean deliveries. If the maximum prevalence proposed by the World Health Organization (WHO) were considered, there would be a potential reduction in spending in the order of R$ 57.7 million (US$ 18,5 million). Cesarean sections are above the parameter recommended by the WHO in all Brazilian regions. The Northeast and Southeast had the highest total number of normal and cesarean deliveries and thus the greatest potential reduction in estimated costs (69.6% of all considered reduction).
Highlights
Cesarean sections have become increasingly common in industrialized and developing countries
The aim of this article is to describe the number of funds paid by Brazilian National Health System (SUS, in Portuguese) to normal delivery and cesarean procedures, according to the five geographical regions in 2015; and to estimate the cost cutting if the World Health Organization (WHO) recommendation regarding the prevalence of cesarean sections were considered
In 2015, 984,307 hospitalizations for delivery were recorded in the five Brazilian regions
Summary
Cesarean sections have become increasingly common in industrialized and developing countries. Faúndes and Cecatti[1] warned about of the increased incidence of cesarean sections in Brazil in the early 1990s: from 14.6% in 1970 to 31% in the 1980s. At that time, they showed to be a phenomenon common to almost all countries of the world, but in no other country the increasing curve was so accentuated and the rates had reached levels as high as in Brazil. The surgical practice (cesarean section) reached 85% of births in private hospitals and 40% in the public health system[2]. As regards the demand of patients, Resolution 2.144 / 2016 of the Federal Council of Medicine[4] states that “It is ethical the REV ASSOC MED BRAS 2018; 64(11):1045-1049
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