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Hospital Expenditure for Microsurgical Peripheral Nerve Repair and the Broader Social Security Burden of Hand and
Mariana Kelly Souto Menezes1, Rudá Guimarães Rocha Justino2, Daniel Torres Jacome1
1Department of Medical Sciences, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Rio de Janeiro, BRA.
Objective:
This study aimed to analyze the epidemiological profile and inflation-adjusted hospital expenditure associated with microsurgical peripheral nerve repairs performed in the Brazilian Unified Health System from 2014 to 2024 and, separately, to contextualize these findings through an ecological analysis of aggregated social security indicators related to traumatic hand, wrist, and related upper-limb injuries, without patient-level linkage between the databases.
Methods:
A retrospective, descriptive, population-based epidemiological study using triangulation of aggregated secondary data from the Hospital Information System of the Unified Health System (SUS), the Statistical Yearbook of Social Security (AEPS)/National Social Security Institute (INSS), and the Institute of Applied Economic Research database (IPEADATA). Hospital Admission Authorizations related to microsurgical peripheral nerve grafts, microneurolysis, and microneuroplasty were included. Nominal hospital costs were adjusted to December 2024 using the Broad National Consumer Price Index.
Results:
A total of 36,177 Hospital Authorizations were identified. Surgical production increased from 2,849 procedures in 2014 to 4,367 in 2019, decreased by 50.2% in 2020, and reached 3,639 procedures in 2024, remaining below the pre-pandemic level. Cumulative hospital expenditure totaled R$37.47 million in nominal values and R$49.69 million after inflation adjustment. In a separate and broader aggregated social security dataset, the accumulated initial monthly income associated with traumatic hand, wrist, and related upper-limb injuries exceeded R$527.6 million. Because the social security population was not restricted to individuals undergoing microsurgical nerve repair and could not be linked to SIH/SUS records, this amount was interpreted exclusively as contextual ecological information rather than as a cost attributable to the microsurgical cohort. The predominant hospital profile was male (81.0%) and 20-39 years old (65.0%), with most admissions classified as urgent (78.0%).
Conclusion:
Microsurgical peripheral nerve repair generated substantial hospital utilization and inflation-adjusted expenditure within the Brazilian Unified Health System. Broader social security data additionally demonstrate the considerable economic magnitude of disability related to traumatic hand, wrist, and upper-limb injuries; however, these aggregated costs cannot be attributed specifically to patients undergoing microsurgical nerve repair. Timely access to reconstruction, integrated rehabilitation, and improved occupational surveillance remain relevant public health priorities.
