Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)

Introduction: The Brazilian health system is organized into basic health units, medium complexity hospitals, and high complexity hospitals. The composition of medium complexity services is variable, with or without specialists such as the plastic surgeon. The objective of the present study is to ana...

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Main Author: Daniele Walter Duarte
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2020-06-01
Series:Revista Brasileira de Cirurgia Plástica
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Online Access:http://www.rbcp.org.br/export-pdf/2746/en_v35n2a08.pdf
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author Daniele Walter Duarte
author_facet Daniele Walter Duarte
author_sort Daniele Walter Duarte
collection DOAJ
description Introduction: The Brazilian health system is organized into basic health units, medium complexity hospitals, and high complexity hospitals. The composition of medium complexity services is variable, with or without specialists such as the plastic surgeon. The objective of the present study is to analyze data on the treatment of patients with skin tumors by a plastic surgeon in a medium complexity hospital. Methods: prospective cohort with analysis of epidemiological, demographic data, costs, results, complications, and degree of satisfaction. Results: In nine months, 166 patients were treated, of whom 103 underwent surgery. The most common pathologies were: basal cell carcinomas, benign subcutaneous and cutaneous tumors, squamous cell carcinoma and melanoma, in decreasing order of appearance. Most of the injuries were treated with exeresis and suture surgery and in 29 patients, more complex reconstructions were required. The degree of resolution of cases was high, and only a patient was derived to a high complexity hospital. The degree of satisfaction with the treatment was also high. However, the estimated financial transfer of SUS, in the case of malignant tumors treatment, was approximately 25% less than it is in a high complexity hospital. Conclusion: The role of the plastic surgeon in medium complexity hospitals can prevent diseases such as skin cancer from reaching high complexity hospitals in advanced stages. However, there would have to be adaptations in the government transfer to enable the routine performance of this professional in these institutions.
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spelling doaj-art-33fbd11d03bc43a88fded4d05b2c61422025-08-20T03:56:13ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352020-06-01350218218810.5935/2177-1235.2020RBCP0031Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)Daniele Walter Duarte0Hospital Ernesto Dornelles, Porto Alegre, RS, BrazilIntroduction: The Brazilian health system is organized into basic health units, medium complexity hospitals, and high complexity hospitals. The composition of medium complexity services is variable, with or without specialists such as the plastic surgeon. The objective of the present study is to analyze data on the treatment of patients with skin tumors by a plastic surgeon in a medium complexity hospital. Methods: prospective cohort with analysis of epidemiological, demographic data, costs, results, complications, and degree of satisfaction. Results: In nine months, 166 patients were treated, of whom 103 underwent surgery. The most common pathologies were: basal cell carcinomas, benign subcutaneous and cutaneous tumors, squamous cell carcinoma and melanoma, in decreasing order of appearance. Most of the injuries were treated with exeresis and suture surgery and in 29 patients, more complex reconstructions were required. The degree of resolution of cases was high, and only a patient was derived to a high complexity hospital. The degree of satisfaction with the treatment was also high. However, the estimated financial transfer of SUS, in the case of malignant tumors treatment, was approximately 25% less than it is in a high complexity hospital. Conclusion: The role of the plastic surgeon in medium complexity hospitals can prevent diseases such as skin cancer from reaching high complexity hospitals in advanced stages. However, there would have to be adaptations in the government transfer to enable the routine performance of this professional in these institutions.http://www.rbcp.org.br/export-pdf/2746/en_v35n2a08.pdfskin neoplasmsunique health systemcosts and cost analysistherapeutic interventions results evaluationplastic surgery
spellingShingle Daniele Walter Duarte
Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)
Revista Brasileira de Cirurgia Plástica
skin neoplasms
unique health system
costs and cost analysis
therapeutic interventions results evaluation
plastic surgery
title Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)
title_full Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)
title_fullStr Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)
title_full_unstemmed Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)
title_short Plastic surgery in a medium complexity hospital: prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the Unified Health System (SUS)
title_sort plastic surgery in a medium complexity hospital prospective cohort with cost and results analysis of the treatment of skin tumors within the scope of the unified health system sus
topic skin neoplasms
unique health system
costs and cost analysis
therapeutic interventions results evaluation
plastic surgery
url http://www.rbcp.org.br/export-pdf/2746/en_v35n2a08.pdf
work_keys_str_mv AT danielewalterduarte plasticsurgeryinamediumcomplexityhospitalprospectivecohortwithcostandresultsanalysisofthetreatmentofskintumorswithinthescopeoftheunifiedhealthsystemsus