Rotator cuff repair in the Brazilian Unified Health System: Brazilian trends from 2003 to 2015☆

Malavolta, Eduardo Angeli; Assunção, Jorge Henrique; Beraldo, Rodrigo Alves; Pinto, Gustavo de Mello Ribeiro; Gracitelli, Mauro Emilio Conforto; Ferreira, Arnaldo Amado

doi:10.1016/j.rboe.2017.06.010

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ORIGINAL ARTICLE • Rev. bras. ortop. 52 (04) • Jul-Aug 2017 • https://doi.org/10.1016/j.rboe.2017.06.010 copy

Rotator cuff repair in the Brazilian Unified Health System: Brazilian trends from 2003 to 2015^☆ ☆ Study conducted at the Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Ortopedia e Traumatologia, Grupo de Ombro e Cotovelo, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To assess the historical trend of rotator cuff repairs in Brazil between 2003 and 2015, using the database of the Brazilian Unified Health System's (Sistema Único de Saúde [SUS]) Department of Informatics (DataSUS).

METHODS:

Historical series using DataSUS. Surgeries performed between 2003 and 2015 were included and data relating to cuff tear repair were assessed, including decompression procedures were included. The numerator was the total number of rotator cuff repair and the denominator, the total population of the assessed locality. Population data were based on information from the Instituto Brasileiro de Geografia e Estatística (IBGE).

RESULTS:

During the period, 50,207 surgeries were performed. The rate was presented as number of procedures per 100,000 inhabitants, and increased from 0.83 to 2.81, a growth of 238%. In 2015, the South region had the highest rate, 6.32, followed by the Southeast, 3.62, while the North had the lowest rate, 0.13. The growing trend can be observed in the Southeast, South, and Midwest, while the rate is stable in the North and Northeast.

CONCLUSION:

The rate of rotator cuff repairs in Brazil performed through the SUS increased from 0.83 to 2.81 between 2003 and 2015, representing a growth of 238%, but remains lower than that of developed countries. A trend of growth can be observed in the Southeast, South, and Midwest, while the rate is stable in the North and Northeast.

Keywords:
Rotator cuff; Shoulder; Public health; Health policy

State/region	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015
Acre	0.16	0.00	0.00	0.15	0.00	0.71	0.14	0.82	0.94	0.00	0.00	0.25	0.37
Amapá	0.00	0.00	0.00	0.00	0.00	0.31	0.00	0.15	0.00	0.00	0.41	0.13	0.78
Amazonas	0.10	0.19	0.34	0.30	0.12	0.40	0.31	0.23	0.03	0.08	0.13	0.08	0.13
Pará	0.15	0.13	0.09	0.45	0.74	0.42	0.57	0.28	0.06	0.03	0.13	0.14	0.09
Rondônia	0.07	0.00	0.00	0.06	0.00	0.12	0.00	0.06	0.12	0.06	0.12	0.00	0.00
Roraima	0.00	0.00	0.00	0.72	0.00	0.23	0.00	0.00	0.00	0.21	0.41	0.40	0.20
Tocantins	0.40	0.47	0.15	0.90	0.66	0.29	0.72	0.07	0.00	0.14	0.27	0.13	0.07
North region	0.14	0.14	0.14	0.39	0.44	0.38	0.41	0.24	0.09	0.05	0.15	0.12	0.13
Alagoas	0.00	0.10	0.03	0.13	0.32	0.28	0.31	0.19	0.34	0.12	0.03	0.06	0.03
Bahia	0.44	0.44	0.73	0.77	0.78	0.71	0.68	0.99	1.16	1.41	1.32	0.96	0.87
Ceará	0.26	0.26	0.38	0.38	0.40	0.40	0.25	0.37	0.31	0.41	0.59	0.43	0.61
Maranhão	0.13	0.08	0.14	0.17	0.25	0.17	0.02	0.11	0.30	0.22	0.25	0.32	0.29
Paraíba	1.51	1.44	0.69	0.79	1.37	0.99	1.03	0.64	0.16	0.33	1.33	2.03	0.65
Pernambuco	0.24	0.29	0.42	0.42	0.26	0.34	0.18	0.27	0.42	0.28	0.28	0.23	0.36
Piauí	0.24	0.80	0.36	0.62	0.19	0.68	1.18	1.03	1.08	1.04	1.16	0.56	1.31
Rio Grande do Norte	0.74	0.89	0.98	0.64	0.35	0.06	0.19	0.16	0.03	0.00	0.03	0.06	0.00
Sergipe	0.36	0.56	0.45	0.90	1.37	0.53	0.05	0.05	0.33	0.46	0.32	0.45	0.94
Northeast region	0.40	0.45	0.49	0.53	0.55	0.48	0.43	0.51	0.58	0.63	0.70	0.60	0.58
Distrito Federal	0.67	1.23	1.55	2.19	1.03	0.93	1.57	1.87	1.91	2.86	3.19	2.87	2.74
Goiás	0.17	0.42	0.85	0.56	0.22	0.72	0.87	0.62	0.78	0.68	1.88	4.40	3.59
Mato Grosso	0.37	0.58	0.46	0.45	0.72	0.68	0.63	0.33	0.39	0.70	0.28	0.40	1.10
Mato Grosso do Sul	0.40	0.40	0.43	0.98	1.13	1.53	1.31	0.69	1.15	1.57	1.89	3.13	3.17
Mid-West region	0.34	0.59	0.82	0.90	0.63	0.89	1.02	0.80	0.97	1.24	1.79	3.05	2.83
Espírito Santo	0.57	0.79	0.58	0.69	1.24	1.19	0.03	0.37	1.28	4.80	9.66	10.48	11.96
Minas Gerais	0.90	1.16	1.21	1.21	1.25	2.46	2.34	2.64	2.67	3.21	3.57	3.07	2.80
Rio de Janeiro	0.85	1.30	1.41	1.91	1.96	1.44	1.93	1.45	2.24	2.78	3.13	3.37	3.46
São Paulo	1.16	1.56	1.85	2.17	2.55	2.99	3.19	3.98	3.60	3.42	3.54	3.59	3.33
Southeast region	1.01	1.38	1.55	1.82	2.06	2.48	2.60	2.99	3.01	3.31	3.75	3.73	3.62
Paraná	2.19	2.75	3.07	2.92	3.90	4.13	5.27	4.23	4.29	5.88	5.14	4.52	4.87
Rio Grande do Sul	1.44	2.00	2.92	4.04	4.20	4.43	4.03	5.05	5.82	5.93	8.43	10.23	8.95
Santa Catarina	1.54	2.43	2.68	2.76	3.39	3.65	4.11	5.12	4.34	5.63	5.40	5.29	4.36
South region	1.75	2.38	2.93	3.33	3.91	4.14	4.52	4.75	4.90	5.84	6.47	6.90	6.32
Brazil	0.83	1.11	1.30	1.50	1.67	1.87	1.97	2.16	2.21	2.50	2.84	2.96	2.81

Region	SBCOC accredited services	Associated members SBCOC
North	0	10.87
Northeast	0.35	19.98
Mid-West	1.3	41.44
Southeast	1.98	59.25
South	1.71	44.82

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] * Corresponding author. E-mail: drjorgeassuncao@gmail.com (J.H. Assunção).

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Rotator cuff repair in the Brazilian Unified Health System: Brazilian trends from 2003 to 2015☆ ☆ Study conducted at the Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Ortopedia e Traumatologia, Grupo de Ombro e Cotovelo, São Paulo, SP, Brazil.

ABSTRACT

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Rotator cuff repair in the Brazilian Unified Health System: Brazilian trends from 2003 to 2015^☆ ☆ Study conducted at the Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Ortopedia e Traumatologia, Grupo de Ombro e Cotovelo, São Paulo, SP, Brazil.