Shoulder Arthroplasties in the Brazilian Unified Health System (SUS) - Number of procedures, regional distribution, hospitalization expenses, average length of stay, and mortality (2012-2021)
DOI:
https://doi.org/10.33448/rsd-v12i7.42750Keywords:
Shoulder replacement surgery; Hospital costs; Regional health planning; Length of stay.Abstract
Objective: To describe the number and regional distribution of hospital admission authorizations (AIH), hospitalization costs, average length of hospital stay (LOS), and mortality related to Shoulder Arthroplasties (SA) funded by the Brazilian Unified Health System (SUS) from 2012 to 2021. Methods: An ecological time-series study was conducted using Datasus data related to SA (codes 04.08.01.005-3 and 04.08.01.004-5) between the years 2012 and 2021. Results: During the evaluated period, there were 7,340 AIH, with 58% classified as urgent, 34% elective, and 8% unidentified. The regional distribution of AIH was 55% for the Southeast, 20% for the South, 19% for the Northeast, 5% for the Midwest, and 1% for the North. The total expenditure was R$ 13,452,071.23, with an average cost per hospitalization of R$ 1,830.96 (SD 96.17). The average length of hospital stay was 7.3 days. The mortality rate was less than 0.01%. The total expenditure was R$ 7,349,277.01 in the Southeast, R$ 2,703,527.69 in the South, R$ 2,698,977.58 in the Northeast, R$ 598,579.30 in the Midwest, and R$ 101,709.65 in the North. The average cost per procedure was higher in the Southeast, amounting to R$ 1955.31, while the lowest was in the North, with R$ 1374.87. Conclusion: The present study aimed to highlight the economic impact of total and partial shoulder arthroplasties on the Brazilian Unified Health System, in order to guide policies regarding the procedure.
References
Khan, A. Z., et al. (2022). Impact of the COVID-19 Pandemic on Shoulder Arthroplasty: Surgical Trends and Post-Operative Care Pathway Analysis. Journal of Shoulder and Elbow Surgery. https://linkinghub.elsevier.com/retrieve/pii/S1058274622006656
Brasil. (2022, 6 de junho). Datasus. Ministério da Saúde. http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sih/cnv/piuf.def
Buck, F. M., Jost, B., & Hodler, J. (2008). Shoulder Arthroplasty. European Radiology, 18(12), 2937–2948. http://link.springer.com/10.1007/s00330-008-1093-8
Checchia, S. L., et al. (2008). Avaliação Dos Resultados Da Artroplastia Parcial de Ombro Para Tratamento Da Artropatia Por Lesão Do Manguito Rotador. Revista Brasileira de Ortopedia, 43(6), 232–239. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162008000600004&lng=pt&nrm=iso&tlng=en
Couto, R. A., Wiener, T. C., & Adams, W. P. (2021). Evaluating Postoperative Outcomes of Patients Undergoing Elective Procedures in an Ambulatory Surgery Center During the COVID-19 Pandemic. Aesthetic Surgery Journal, 41(2), 250–257. https://academic.oup.com/asj/article/41/2/250/5864814
Dunn, J. C., et al. (2015). Predictors of Length of Stay after Elective Total Shoulder Arthroplasty in the United States. Journal of Shoulder and Elbow Surgery, 24(5), 754–759. https://linkinghub.elsevier.com/retrieve/pii/S1058274614006648
Felson, D. T., et al. (2001). The Association of Bone Marrow Lesions with Pain in Knee Osteoarthritis. Annals of Internal Medicine, 134(7), 541. http://annals.org/article.aspx?doi=10.7326/0003-4819-134-7-200104030-00007
Ferreira Neto, A. A., et al. (2017). Reverse Shoulder Arthroplasty: Clinical Results and Quality of Life Evaluation. Revista Brasileira de Ortopedia (English Edition), 52(3), 298–302. https://linkinghub.elsevier.com/retrieve/pii/S2255497117300538
Gonçalves Costa, B. M., et al. (2020). Hemiartroplastia Do Ombro Para Tratamento de Luxação Glenoumeral Posterior Inveterada Associada a Osteocondroma. Técnicas em Ortopedia, 20(3), 20–26.
Gregory, T., et al. (2014). A CT Scan Protocol for the Detection of Radiographic Loosening of the Glenoid Component after Total Shoulder Arthroplasty. Acta Orthopaedica, 85(1), 91–96. http://www.tandfonline.com/doi/full/10.3109/17453674.2013.869653
Guedes, A. (2020). Proposta de Protocolo de Segurança Hospitalar Para Abordagem de Pacientes Ortopédicos No Contexto da pandemia COVID-19. Fundação Getúlio Vargas.
Jain, N. B., et al. (2005). Total Arthroplasty versus Hemiarthroplasty for Glenohumeral Osteoarthritis: Role of Provider Volume. Journal of Shoulder and Elbow Surgery, 14(4), 361–367. https://linkinghub.elsevier.com/retrieve/pii/S1058274604002976
Jain, N. B. (2006). Trends in the Epidemiology of Total Shoulder Arthroplasty in the United States from 1990–2000. Arthritis & Rheumatism, 55(4), 591–597. https://onlinelibrary.wiley.com/doi/10.1002/art.22102
Kim, S. H., Szabo, R. M., & Marder, R. A. (2012). Epidemiology of Humerus Fractures in the United States: Nationwide Emergency Department Sample, 2008. Arthritis Care Res (Hoboken), 64(3), 407–414.
Kim, S. H., Wise, B. L., Zhang, Y., & Szabo, R. M. (2011). Increasing Incidence of Shoulder Arthroplasty in the United States. The Journal of Bone and Joint Surgery-American Volume, 93(24), 2249–2254. http://journals.lww.com/00004623-201112210-00003
Lovald, S. T., et al. (2014). Complications, Mortality, and Costs for Outpatient and Short-Stay Total Knee Arthroplasty Patients in Comparison to Standard-Stay Patients. The Journal of Arthroplasty, 29(3), 510–515. https://linkinghub.elsevier.com/retrieve/pii/S088354031300538X
Manoli, A., Capriccioso, C. E., Konda, S. R., & Egol, K. A. (2016). Total Shoulder Arthroplasty for Proximal Humerus Fracture Is Associated with Increased Hospital Charges despite a Shorter Length of Stay. Orthopaedics & Traumatology: Surgery & Research, 102(1), 19–24. https://linkinghub.elsevier.com/retrieve/pii/S1877056815003114
McCormick, F., et al. (2015). In-Hospital Mortality Risk for Total Shoulder Arthroplasty: A Comprehensive Review of the Medicare Database from 2005 to 2011. International Journal of Shoulder Surgery, 9(4), 110. http://www.internationalshoulderjournal.org/text.asp?2015/9/4/110/167938
Menendez, M. E., et al. (2021). Variation in the Value of Total Shoulder Arthroplasty. Journal of Shoulder and Elbow Surgery, 30(8), 1924–1930. https://linkinghub.elsevier.com/retrieve/pii/S1058274620309149
Motta Filho, G., et al. (2009). Registro de Artroplastias Do Ombro. Revista Brasileira de Ortopedia, 44(2), 125–133. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162009000200007&lng=pt&nrm=iso&tlng=en
Naito, G. M., Pimentel, C. S. S., Silva, R. R. da, Guedes, A. A. L., & Guedes, A. (2022). Primary total knee arthroplasties under the Brazilian Public Health Unified System (SUS) - Number of procedures, regional distribution, hospitalization costs, average length of hospital stay and mortality (2012-2021). Research, Society and Development, 11(5), e38711528548. 10.33448/rsd-v11i5.28548. https://rsdjournal.org/index.php/rsd/article/view/28548. Acesso em: 29 jul. 2023.
Nepogodiev, D., et al. (2020). Mortality and Pulmonary Complications in Patients Undergoing Surgery with Perioperative SARS-CoV-2 Infection: An International Cohort Study. The Lancet, 396(10243), 27–38. https://linkinghub.elsevier.com/retrieve/pii/S014067362031182X
Nho, S. J., Kymes, S. M., Callaghan, J. J., & Felson, D. T. (2013). The Burden of Hip Osteoarthritis in the United States: Epidemiologic and Economic Considerations. Journal of the American Academy of Orthopaedic Surgeons, 21(suppl), S1–S6. http://www.jaaos.org/cgi/doi/10.5435/JAAOS-21-07-S1
Norris, T. R., & Iannotti, J. P. (2002). Functional Outcome after Shoulder Arthroplasty for Primary Osteoarthritis: A Multicenter Study. Journal of Shoulder and Elbow Surgery, 11(2), 130–135. https://linkinghub.elsevier.com/retrieve/pii/S1058274602120258
Oppermann, J., et al. (2016). Shoulder Arthroplasty in Germany: 2005–2012. Archives of Orthopaedic and Trauma Surgery, 136(5), 723–729. http://link.springer.com/10.1007/s00402-016-2417-9
Osterhoff, G., et al. (2017). A Cost-Effectiveness Analysis of Reverse Total Shoulder Arthroplasty versus Hemiarthroplasty for the Management of Complex Proximal Humeral Fractures in the Elderly. Value in Health, 20(3), 404–411. https://linkinghub.elsevier.com/retrieve/pii/S1098301516340700
Rogers, M. J., Kahn, T. L., Kim, J., & Chalmers, P. N. (2022). Factors Associated with Total Shoulder Arthroplasty Cost Variation in the State of Utah. Seminars in Arthroplasty: JSES. https://linkinghub.elsevier.com/retrieve/pii/S1045452722000517
Serino, J., Burnett, R. A., Della Valle, C. J., & Courtney, P. M. (2022). National Trends in Post-Acute Care Costs Following Total Hip Arthroplasty from 2010 through 2018. Journal of Bone and Joint Surgery, 104(3), 255–264. https://journals.lww.com/10.2106/JBJS.21.00392
Storti, T. M., et al. (2022). Artroplastia Reversa de Ombro: Avaliação Dos Resultados Clínicos e Funcionais de Acordo Com a Etiologia. Revista Brasileira de Ortopedia, 57(05), 868–875. http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1731674
Verhaegen, F., et al. (2022). Quantitative Statistical Shape Model‐based Analysis of Humeral Head Migration, Part 2: Shoulder Osteoarthritis. Journal of Orthopaedic Research. https://onlinelibrary.wiley.com/doi/10.1002/jor.25335
Wagner, E. R., et al. (2020). The Incidence of Shoulder Arthroplasty: Rise and Future Projections Compared with Hip and Knee Arthroplasty. Journal of Shoulder and Elbow Surgery, 29(12), 2601–2609. https://linkinghub.elsevier.com/retrieve/pii/S1058274620303517
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