Brazilian Health Care Research Articles

Appendectomy: Cross-sectional study of the effects of COVID-19 in a hospital in South Brazil

BackgroundCOVID-19 has further burdened the Brazilian healthcare system, especially emergencies. Patients may have delayed seeking care for surgical abdominal pain. Delays in the approach may have impacted clinical evolution and outcomes. This study evaluated appendectomies and their complications performed by the public system during one-year follow-up of COVID-19 in a hospital in southern Brazil. Materials and methodsIn this hospital-based cross-sectional study, we included adult patients who underwent appendectomy from March 2019 to April 2021 (n = 162). Patients were divided into pre-pandemic (n = 78) and pandemic (n = 84) groups based on the surgery date. The analyzed variables included hospitalization duration, intensive care unit (ICU) admission, surgical approach, histopathological findings, COVID-19 testing, patient outcomes, and 30-day survival rate. ResultsThe cohorts exhibited similar epidemiology, with the sex ratio and average age being maintained. No statistical difference was found in the 30-day survival rate and clinical outcomes. Of the four patients admitted to the ICU, three belonged to the pandemic cohort and tested negative for COVID-19. Only 47.6 % of the patients in the pandemic cohort underwent COVID-19 polymerase chain reaction examination; one tested positive (2.5 %). ConclusionThis study demonstrated that there was no increased risk for appendectomies during the first wave of the pandemic. Surgeries were safe during this period. Patients continued to access the emergency service despite surgical abdominal pain and restrictive measures imposed by health authorities. The similar results observed across cohorts are attributed to the readiness of the teams and the availability of medical surgical equipment in safe quantities.

Primary care performance measurement in Brazil (Previne Brasil Program), 2022–2023

BackgroundPrevine Brasil is a new way of financing Primary Health Care (PHC) in Brazil that places users of public health services at the center of the system’s analysis and attention through the use of seven performance indicators. This study aims to analyze the performance of Primary Health Care in Brazil under the new financing model (Previne Brasil) in the period from the first four months of 2022 to the first four months of 2023.MethodsThis is a territorial ecological study using secondary data from the Primary Care Health Information System (SISAB). Seven performance indicators were included and analyzed according to Brazil, its regions, states and capitals. A comparative descriptive analysis was carried out between the spatial units.ResultsOf the seven indicators analyzed, only one (Proportion of pregnant women tested for syphilis and HIV) reached the proposed target considering the average of the four-month periods evaluated (target: 60%; Observed: 62.5%). The Northeast was the region with the best performance, surpassing the target in three of the seven indicators (prenatal consultations, tests for syphilis and HIV in pregnant women and dental care for pregnant women). The states and capitals showed progressive improvement in the performance indicators over the four quarters analyzed, although unevenly between the indicators. The indicators related to hypertension and diabetes were the worst. The Final Synthetic Indicator (FSI) showed an increase in the median over the four quarters (4.78; 5.65; 6.02 6.29), which represents an increase of 1.51 in the indicator between the first four months of 2022 and the first four months of 2023.ConclusionAlthough there have been improvements in the performance of Primary Health Care in Brazil, the achievement of the agreed targets for the indicators seems a long way off. The socio-spatial inequalities in the indicators reflect the country’s health complexity and reinforce the need for policies that take into account the local-regional context.

Adopting a pedagogy of connection for medical education.

In this article, we propose developing a "pedagogy of connection" based on the history and evolution of medical education in Brazil. This pedagogy emerged from the intersection of the healthcare and higher educational systems, both dedicated to the principles of social justice and universal access, in response to the country's efforts to address the enduring impacts of slavery and social inequality. Following the "Sanitary Reformation" movement-a foundational moment for Brazil's healthcare and medical education systems-Brazil established the Unified Public Healthcare System (Sistema Único de Saúde - SUS). SUS is founded on principles of universality, integrality, equity, community participation, political and administrative decentralisation, hierarchisation and regionalisation. Aligned with these core principles and inspired by critical pedagogy, Brazilian medical education has evolved with a profound commitment to social justice, critical consciousness, professional presence and compassion. This evolution has given rise to a "pedagogy of connection," which imbues medical education with a sense of purpose and joy, preparing future medical professionals to address the challenges of our ever-evolving society and healthcare systems. The connections fostered by this pedagogy occur in complementary dimensions: (a) healthcare system and society, (b) community, (c) profession, (d) patients, and (e) ourselves. This innovative pedagogy enhances medical education discourse and practice by emphasising the development of a professional identity grounded in social justice and patient-centred care, which remain challenges for current medical education systems. As the global medical education community embraces decolonisation, this pedagogy offers a framework that can be adapted and enriched in various contexts worldwide, fostering opportunities for mutual learning from diverse educational systems in a dialogical and democratic manner.

Mental health care measures and innovations to cope with COVID-19: an integrative review.

This integrative review aims to identify the mental health care measures that were produced during the COVID-19 pandemic. This research was conducted on three databases (SciELO, PubMed, and LILACS) with the following descriptors in Portuguese, English, and Spanish: "SAÚDE MENTAL" or "SALUD MENTAL" or "MENTAL HEALTH" AND "COVID-19" from 2020 to 2021. In total, 3,451 articles were found, 43 of which were analyzed. Most measures were digital, stemmed from public institutions, focused on the local perspective, and were integrated with the public health care system. This study discusses the models of care in mental health based on measures to cope with the COVID-19 pandemic. It also discusses the Brazilian health care system, reiterating its resilience. In conclusion, digital measures occurred most often. This study suggest the evaluation of the accessibility of this mental health care model for most vulnerable groups. Finally, this research reinforces the importance of the Brazilian health care system for public health and access to information to cope with the COVID-19 pandemic.

Evaluation of medical professionals’ knowledge about Q fever

Aims: evaluate the medical professionals’ knowledge about Q fever, seeking integrative contributions to public health that may favor the formulation of policies and the development of strategies based on a One Health approach. Methods: this is a cross-sectional and quantitative study with data collection through a structured questionnaire applied face-to-face to physicians from various clinical specialties working at the three levels of health care in Brazil. The questionnaire consisted of 25 questions, seven of which were specific to assessing knowledge about Q fever. Univariate and multivariate logistic regression analyses were conducted to assess whether the variables medical specialty, level of health care in which they work, age range and gender were associated with a correct answer to at least one specific question about Q fever. Results: among the 254 physicians included, 236 (92.9%) were unaware of Q fever. Only three (16.6%) of the 18 who correctly answered at least one specific question about the disease had a score of more than 50%. The highest rates of correct answers for at least one question (p < 0.0001) occurred among the medical specialties most related to clinical signs and symptoms or the differential diagnosis of Q fever and among males. It is highlighted that 85.8% of physicians consider Q fever a neglected and underreported disease in Brazil. Additionally, all physicians responded that they were not aware of the One Health approach. Conclusions: the almost total lack of knowledge among medical professionals regarding Q fever reinforces the need for greater disclosure for this zoonosis with a One Health approach in Medical Schools, in Residency Programs and for physicians in general. In addition, the inclusion of Q fever in the national list of notifiable diseases becomes relevant, allowing a better understanding of its epidemiological situation in Brazil. Finally, effective public health actions must be carried out to avoid underdiagnosis and the development of severe cases of the disease. Methods: this is a cross-sectional and quantitative study with data collection through a structured questionnaire applied face-to-face to physicians from various clinical specialties working at the three levels of health care in Brazil. The questionnaire consisted of 25 questions, seven of which were specific to assessing knowledge about Q fever. Univariate and multivariate logistic regression analyses were conducted to assess whether the variables medical specialty, level of health care in which they work, age range and gender were associated with a correct answer to at least one specific question about Q fever. Results: among the 254 physicians included, 236 (92.9%) were unaware of Q fever. Only three (16.6%) of the 18 who correctly answered at least one specific question about the disease had a score of more than 50%. The highest rates of correct answers for at least one question (p < 0.0001) occurred among the medical specialties most related to clinical signs and symptoms or the differential diagnosis of Q fever and among males. It is highlighted that 85.8% of physicians consider Q fever a neglected and underreported disease in Brazil. Additionally, all physicians responded that they were not aware of the One Health approach. Conclusions: the almost total lack of knowledge among medical professionals regarding Q fever reinforces the need for greater disclosure for this zoonosis with a One Health approach in Medical Schools, in Residency Programs and for physicians in general. In addition, the inclusion of Q fever in the national list of notifiable diseases becomes relevant, allowing a better understanding of its epidemiological situation in Brazil. Finally, effective public health actions must be carried out to avoid underdiagnosis and the development of severe cases of the disease.

Beyond the Pandemic: Longitudinal Lessons on Social Support, Sleep Quality, and Burnout Among Healthcare Workers.

To assess occupational burnout (OB) changes among Brazilian healthcare workers (HCWs) from COVID-19 onset to six months later (T1) and identify risk and protective factors. Using the Copenhagen Burnout Inventory and hierarchical multivariate linear regression in a two-stage online survey (initial n = 1,054; T1 n = 316), this study examined the impact of various factors on OB. Significant increases in personal and work-related OB were observed by T1. Psychiatric diagnosis and workload emerged as risk factors (p < 0.01), while having a partner, good family relations, workplace well-being, and adequate sleep were protective (p < 0.001). OB levels among Brazilian HCWs increased during the COVID-19 pandemic. Interventions should target personal and organizational wellness to alleviate burnout, emphasizing the importance of strong relationships, workplace health, and good sleep practices.

Preparation and validation of the instrument "QualiAPS digital-Brazil" for assessing digital health care in primary health care: a required tool.

The use of Information and Communication Technologies in the field of health is increasing across the world, demarcating the field of digital health. The goal of this study is to formulate and validate a matrix of indicators, design assessment scripts and indicate data collection techniques for assessing the quality of digital health care in Brazilian Primary Health Care (PHC). This is a validation study divided into three phases: preparation of the instrument, analysis of validity and pilot study. The instrument was prepared based on the PHC assessment model from a literature review; the analysis of validity used the Delphi technique associated with the nominal group and the evidence from the literature reference. In the pilot study, audio-recorded interviews were conducted with strategic primary care actors. The matrix of indicators "QualiAPS Digital-Brazil" introduces a set of 37 indicators, distributed into three distinct components and their respective dimensions. The component "Structure" includes the dimension "Resources"; the component "Processes" includes the dimensions "Technical," "Organizational" and "Relational"; and the component "Results" includes the dimensions "Short-Term Results" and "Medium-Term Results." The general values obtained for CVI and IRR were 0.89 and 1.00; respectively. Therefore, it was possible to design assessment scripts and indicate qualitative data collection techniques for assessing digital health in Brazilian PHC. The instrument presented was validated regarding its relevance, content and theoretical support to evaluate the quality of digital health care, supporting decision-making by managers and health professionals in the search for improving remote primary care provided to the population.

Brazilian consensus recommendations on the diagnosis and treatment of autoimmune encephalitis in the adult and pediatric populations.

Autoimmune encephalitis (AIE) is a group of inflammatory diseases characterized by the presence of antibodies against neuronal and glial antigens, leading to subacute psychiatric symptoms, memory complaints, and movement disorders. The patients are predominantly young, and delays in treatment are associated with worse prognosis. With the support of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, ABN) and the Brazilian Society of Child Neurology (Sociedade Brasileira de Neurologia Infantil, SBNI), a consensus on the diagnosis and treatment of AIE in Brazil was developed using the Delphi method. A total of 25 panelists, including adult and child neurologists, participated in the study. The panelists agreed that patients fulfilling criteria for possible AIE should be screened for antineuronal antibodies in the serum and cerebrospinal fluid (CSF) using the tissue-based assay (TBA) and cell-based assay (CBA) techniques. Children should also be screened for anti-myelin oligodendrocyte glucoprotein antibodies (anti-MOG). Treatment should be started within the first 4 weeks of symptoms. The first-line option is methylprednisolone plus intravenous immunoglobulin (IVIG) or plasmapheresis, the second-line includes rituximab and/or cyclophosphamide, while third-line treatment options are bortezomib and tocilizumab. Most seizures in AIE are symptomatic, and antiseizure medications may be weaned after the acute stage. In anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, the panelists have agreed that oral immunosuppressant agents should not be used. Patients should be evaluated at the acute and postacute stages using functional and cognitive scales, such as the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Modified Rankin Scale (mRS), and the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). The present study provides tangible evidence for the effective management of AIE patients within the Brazilian healthcare system.

Improving patient-centered mental health promotion in primary care in vulnerable communities through mindfulness training in Rio de Janeiro, Brazil.

Brazilian Primary Health Care (PHC) is responsible for all-sanitary actions for a community-based population, including health promotion and mental health care. Mindfulness Based Health Promotion (MBHP) is an intervention that can promote self-care and psychosocial support in PHC. To discuss the effects of mindfulness based psychosocial group interventions for health promotion in primary care units in Rio de Janeiro, Brazil. The intervention was based on the MBHP model adapted for SUS. Nine groups were held in Rio de Janeiro. A quali-quanti research was held with two parts: (a) quantitative study, pre and after the 8 weeks intervention, evaluating the effect on mindfulness and self-compassion and their association with levels of anxiety, depression, and quality of life. (b) Qualitative research using Focus Groups with the participants to investigate their experience at the end of the mindfulness groups. Sixty-two participants finished the 9 groups where 86% were women, mostly between 30 and 59 years of age and low income, and around 80% under regular medical care in PHC in SUS. In the studied sample 80% had at least one chronic health condition under treatment, including 42% with anxiety and 35% with depression. The effects included significant improvement in Anxiety and Depression and in Quality of Life, mainly in the psychological but also in the physical and interrelation domains. The qualitative study showed that most patients joined the group on the recommendation of health professionals for managing physical and mental health symptoms. Patients reported being able to use the practices taught in the sessions to manage symptoms such as insomnia and emotionally distressing situations in their daily lives. Including family members in mindfulness practices was a strategy to negotiate not only a space at home to meditate, but also to obtain a different approach to health problems. Participants pointed to mindfulness as a complementary therapeutic option to medication and psychotherapy. Mindfulness-Based Intervention have shown to be a feasible, well-accepted and efficacious method of offering psychosocial support and promoting well-being for low-income patients in primary care in LAMIC.

RWD81 Economic Impact of Epilepsy in Private Healthcare in Brazil

RWD81 Economic Impact of Epilepsy in Private Healthcare in Brazil

Spectrum of germline pathogenic variants in Brazilian hereditary breast/ovarian cancer cases.

To define the spectrum of germline pathogenic variants (PVs) and copy number variant (CNV) in cancer susceptibility genes to the burden of breast and ovarian cancer (BC, OvC) in high-risk Brazilians in Minas Gerais with health insurance, southeast Brazil, undergoing multigene panel testing (MGPT). Genotyping eligible individuals with health insurance in the Brazilian healthcare system for Hereditary Breast and Ovarian Cancer Syndrome to undergo molecular testing for 44 or 141-gene panels, a decision that was insurance driven. Overall, 701 individuals clinically defined as high BC/OvC risk, underwent MGPT from 1/2021 to 10/2022, with ~ 50% genotyped with a 44-gene panel and the rest with a 141-gene panel. Overall, 16.4% and 22.6% of genotyped individuals harbored PVs using 44-gene and the 141 gene panel, respectively. The most frequently mutated genes were: BRCA2 (3.7%); BRCA1 (3.6%) and monoallelic MUTYH (3.1%). The rate of PVs detected in high-risk individuals in this study was twice the 10% threshold used in Brazilian health guidelines. MGPT doubled the detection rate of PVs in cancer susceptibility genes in high-risk individuals compared with BRCA1/BRCA2 genotyping alone. The spectrum of PVs in Southern Brazil is diverse, with few recurring variants such as TP53 (0.6%), suggesting regional founder effects. The use of MGPT in hereditary cancer in Minas Gerais significantly increased the detection rate of P/LPVs compared to existing guidelines and should be considered as the primary genotyping modality in assessing hereditary cancer risk in Brazil.

Frailty identification and management among Brazilian healthcare professionals: a survey

BackgroundNational and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice.MethodsAn anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil.ResultsMost of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p < 0.001 for all). Those with fewer years of experience were more likely to evaluate frailty (p = 0.009). Being a doctor increased the chance of using a specific tool; the opposite was true for dietitians (p = 0.03). Those who assisted more older people had a higher likelihood of having a plan (p = 0.011).ConclusionFrailty assessment was heterogeneous among healthcare professions groups, predominantly using non-specific criteria. Training contributed to frailty assessment, use of specific criteria, confidence, and having a management plan. This data informs the need for standardized screening criteria and management plans for frailty, in association with increasing training at the national level for all the HCPs who assist older people.

RWD191 Real-World Ovarian Cancer Mortality Outcomes in a Brazilian Reference Women Healthcare Public Hospital

RWD191 Real-World Ovarian Cancer Mortality Outcomes in a Brazilian Reference Women Healthcare Public Hospital

RWD149 Real-World Endometrial Cancer Mortality Outcomes at Brazilian Reference Women Healthcare Public Hospital

RWD149 Real-World Endometrial Cancer Mortality Outcomes at Brazilian Reference Women Healthcare Public Hospital

Prevalence of modifiable risk factors among patients hospitalized for acute coronary syndrome in Brazil: a call to action for Brazilian healthcare

Prevalence of modifiable risk factors among patients hospitalized for acute coronary syndrome in Brazil: a call to action for Brazilian healthcare

Innovative performance-based remuneration model for oncologists: Balancing productivity with quality of care in a Brazilian healthcare setting.

e23089 Background: Traditional fee-for-service (FFS) models in oncology often lead to biased healthcare delivery, prioritizing quantity over quality of care. Our objective was to develop and implement a comprehensive remuneration model for oncologists in Brazil that emphasizes both productivity and quality in patient care. Methods: The '4E' model forms the basis of our remuneration strategy. 'Effectiveness' measures clinical productivity through patient consultations, treatments, and participation in multidisciplinary activities. 'Structure' evaluates academic credentials and scientific contributions, 'Efficiency' examines adherence to clinical and administrative protocols, and 'Excellence' assesses quality interactions with patients and healthcare systems. These elements provide nuanced bonus adjustments to the effectiveness score, facilitating a balanced and comprehensive compensation approach. Adapted to various healthcare settings, the model accommodates different budgeting methodologies. Results: Implemented in February 2020, the model has led to significant improvements in service delivery. Between May 2020 and August 2023, consultations in private services increased by 36.8%, and patient numbers grew by 42.2%. The financial impact was notable, with more than a doubling of revenue, reflecting the model's success in enhancing both the volume and quality of healthcare provision. Conclusions: This multi-level remuneration model offers a comprehensive, ethical approach, aligning physician compensation with a broad range of professional activities and responsibilities. It demonstrates potential for enhancing healthcare delivery quality while ensuring financial sustainability. However, a limitation of our study is the lack of longitudinal quality measurement, an aspect we aim to address in future research. This suggests the model's replicability in diverse global oncology settings and underscores its relevance in the current healthcare landscape.

Perceptions of physicians on the use of screening tools for mental disorders in primary health care in Brazil.

This study aimed to analyse perceptions, knowledge and ways of incorporating screening tools for mental disorders (MDs) into the daily practice of physicians working in primary health care (PHC) in the Brazilian public health system. This is a descriptive qualitative study with a sample of 24 physicians. The data collected in the semi-structured interviews were subjected to reflective thematic analysis. The use of screening tools was low, not only due to lack of knowledge, but also due to reasoned criticism of this strategy developed by physicians trained in PHC. Physicians also presented a scenario of chaos, work overload and the fragility of the psychosocial care network as barriers to effective care of patients with MDs and to the incorporation of innovations in this care. Interventions aimed at improving the quality of mental health care should include training on the topic, (re)organizing work processes, strengthening the health care network and producing robust scientific evidence on interventions aimed at qualifying professionals in mental health in PHC.

The cost of genetic diagnosis of suspected hereditary pediatric cataracts with whole-exome sequencing from a middle-income country perspective: a mixed costing analysis

Up to 25% of pediatric cataract cases are inherited. There is sparse information in the literature regarding the cost of whole-exome sequencing (WES) for suspected hereditary pediatric cataracts. Molecular diagnosis of suspected hereditary pediatric cataracts is important for comprehensive genetic counseling. We performed a partial economic evaluation with a mixed costing analysis, using reimbursement data and microcosting approach with a bottom-up technique to estimate the cost of using WES for genetic diagnosis of suspected hereditary pediatric cataracts from the perspective of the Brazilian governmental health care system. One hundred and ten participants from twenty-nine families in Rio de Janeiro (RJ) were included. Costs of consumables, staff and equipment were calculated. Two scenarios were created: (1) The reference scenario included patients from RJ with suspected hereditary pediatric cataracts plus two family members. (2) The alternative scenario considered other genetic diseases, resulting in 5,280 exams per month. Sensitivity analysis was also performed. In the reference scenario, the total cost per exam was 700.09 United States dollars (USD), and in the alternative scenario, the total cost was 559.23 USD. The cost of WES alone was 527.85 USD in the reference scenario and 386.98 USD in the alternative scenario. Sensitivity analysis revealed that the largest costs were associated with consumables in both scenarios. Economic evaluations can help inform policy decisions, especially in middle-income countries such as Brazil.

A healthcare claims analysis to identify and characterize patients with suspected X-Linked Myotubular Myopathy (XLMTM) in the Brazilian Healthcare System

BackgroundX-linked myotubular myopathy (XLMTM) is a rare, life-threatening congenital disease, which is not well-defined. To our knowledge, no studies characterizing the XLMTM disease burden have been conducted in Brazil. We identified and described patients with suspected XLMTM using administrative claims data from the Brazilian public healthcare system.MethodsData from 2015 to 2019 were extracted from the DATASUS database. As no XLMTM-specific ICD-10 code was available, a stepwise algorithm was applied to identify patients with suspected XLMTM by selecting male patients with a congenital myopathies code (G71.2), aged < 18 years at index date (first claim of G71.2), with an associated diagnostic procedure (muscle biopsy/genetic test) and without spinal muscular atrophy or Duchenne muscular dystrophy. We attempted to identify patients with suspected severe XLMTM based on use of both respiratory and feeding support, which are nearly universal in the care of XLMTM patients. Analyses were performed for the overall cohort and stratified by age at index date < 5 years old and ≥ 5 years old.ResultsOf 173 patients with suspected XLMTM identified, 39% were < 5 years old at index date. Nearly all (N = 166) patients (96%) were diagnosed by muscle biopsy (91% of patients < 5 years old and 99% of patients ≥ 5 years old), six (3.5%) were diagnosed by clinical evaluation (8% of patients < 5 years old and 1% of patients ≥ 5 years old), and one was diagnosed by a genetic test. Most patients lived in Brasilia (n = 55), São Paulo (n = 33) and Minas Gerais (n = 27). More than 85% of patients < 5 years old and approximately 75% of patients ≥ 5 years old had physiotherapy at the index date. In both age groups, nearly 50% of patients required hospitalization at some point and 25% required mobility support. Respiratory and feeding support were required for 3% and 12% of patients, respectively, suggesting that between 5 and 21 patients may have had severe XLMTM.ConclusionIn this real-world study, genetic testing for XLMTM appears to be underutilized in Brazil and may contribute to underdiagnosis of the disease. Access to diagnosis and care is limited outside of specific regions with specialized clinics and hospitals. Substantial use of healthcare resources included hospitalization, physiotherapy, mobility support, and, to a lesser extent, feeding support and respiratory support.

Microcosting Analysis of Advanced Ovarian Cancer: Real-World Evidence From the Perspective of a Reference Public Brazilian Hospital

ObjectivesEvaluate the cost of advanced ovarian cancer, using the microcosting technique, based on real-world evidence from the perspective of a reference Brazilian public hospital. MethodsRetrospective cohort study of patients newly diagnosed with advanced ovarian cancer in 2017 and followed-up for up to 5 years. A bottom-up microcosting method was applied, using the activity-based cost approach, which evaluates service costs based on activity consumption throughout patients’ journey. ResultsThe results indicate a median overall survival of 35.3 months and a median age of 57 years (33-80 years old). The average cost per patient was USD 34 991.595 over a period of 35.3 months, with admissions because of the disease progression and end-of-life care being the most relevant. ConclusionsThe results show that the costs of activities currently involved in the treatment of advanced ovarian cancer represent an important economic impact for the public health system. These data can support future analyses on the impact of incorporating new technologies for the treatment of ovarian cancer and on the financing and sustainability of the Brazilian public healthcare system.