Demographic and economic disparities in hand surgical procedures in Brazil: Analysis of DATASUS data

To analyze epidemiological, demographic, and health cost data of major hand surgery procedures in Brazil's public health system and explore inequalities, regional utilization patterns, and economic impact to inform policy improvements.

This cross-sectional study analyzed 1,026,582 hand surgery procedures from DATASUS (2018-2024). The data included distal radius fractures, amputations, replantations, carpal tunnel syndrome, and brachial plexus injuries linked to ICD-10 codes. The variables included sex, race/color, age, geographic region, and hospital costs. Statistical analysis employed one-way ANOVA, Tukey's test, χ2, Pearson's correlation, confidence intervals, and significance was set at p<0.05. The analysis used SPSS v.26, Minitab v.21.2, and Excel 2010.

Health procedures were predominantly performed in male patients (53.5%, n=549.641) and were concentrated in the Southeast region (38.1%, n=391,340). Significant regional variation was observed in total procedure costs, with higher mean values in the South (mean=458,82, SD=455,20, p<0.001), Southeast (mean=453.75, SD=458.93, p<0,001) and West-Central (mean=480,09, SD=446.24, p<0,001) regions. Urgent admissions accounted for 72% of cases, reflecting the traumatic profile of hand surgery within the Brazilian Public Health System. Regarding procedure type, regional disparities were evident, with high-complexity surgeries such as those for brachial plexus injuries costing most in the South (Mean=1295,61, SD=502.28, p<0.001), and low-complexity procedures (for carpal tunnel syndrome) showing higher mean costs in the South (Mean=476.55, SD=348.50, p<0.001) and West-Central regions (Mean=396.38, SD=160.04, p<0.001).

DATASUS data showed that procedures were concentrated in the Southeast region (38.1%) and were predominantly performed in men (53.5%), with 72% of the procedures classified as urgent. Higher mean costs were noted in the West-Central/Southeast/South than in the North/Northeast. Brazil requires adequate infrastructure and training to ensure equitable access to healthcare.