Comparative Analysis of Surgery-to-Consultation Ratios Across Surgical Specialties at a Brazilian Tertiary Referral...

Evaluating the relationship between outpatient consultations and surgical procedures is essential for hospital management, resource allocation, and healthcare planning. This study aimed to characterize surgical activity at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC-USP) and the Hospital das Clínicas de Bauru (HC-Bauru), identify the surgical specialties with the highest surgery-to-consultation ratios, and determine the most frequently performed procedures in 2023 and 2024.

A retrospective, descriptive study was conducted using institutional administrative databases from HRAC-USP and HC-Bauru. Data on outpatient consultations and surgical procedures performed between January 2023 and December 2024 were analyzed. The surgery-to-consultation ratio was defined as the number of surgical procedures divided by the number of outpatient consultations performed by the same specialty within the same calendar year. Because the analysis was based on aggregated institutional data rather than linked patient-level records, this metric represents an institutional activity indicator and should not be interpreted as the proportion of patients progressing from consultation to surgery. Descriptive statistics were used to summarize institutional activity. Ratios were compared between years using the two-proportion Z test, and relative risks (RRs) with 95% confidence intervals (95% CIs) were calculated.

A total of 25,849 outpatient consultations and 3,285 surgical procedures were recorded in 2023, compared with 65,535 consultations and 7,004 procedures in 2024. Although surgical volume increased substantially, the overall surgery-to-consultation ratio decreased from 12.7% to 10.7% (RR = 0.84, 95% CI 0.81-0.87; p < 0.001). Plastic Surgery remained the specialty with the highest surgical volume and showed a significant increase in the surgery-to-consultation ratio, from 41.3% to 86.8% (RR = 2.10, 95% CI 2.02-2.18; p < 0.001). Otorhinolaryngology remained the second-highest surgical specialty, with the ratio increasing from 8.9% to 10.3% (RR = 1.16, 95% CI 1.08-1.24; p < 0.001). Pediatric Surgery ranked third in surgical volume in 2023, whereas Gastroenterology became the third-highest-volume specialty in 2024. The most frequently performed procedures included septorhinoplasty, rhinoplasty, primary palatoplasty, turbinectomy, adenotonsillectomy, otologic microsurgery, and laparoscopic cholecystectomy.

This study provides a comprehensive overview of outpatient and surgical activity within a specialized tertiary referral hospital complex and highlights changes in specialty-specific surgical activity over time. The surgery-to-consultation ratio is a practical institutional indicator of surgical activity relative to outpatient workload and may support hospital planning, resource allocation, and future evaluations of healthcare service organization and surgical productivity.