Pent-up demand for surgery in the Manaus metropolitan region

Abstract

Waiting lines in healthcare reflect an imbalance between the availability and the demand for medical services. This study aimed to analyze the prevalence and factors associated with the pent-up demand for surgical procedures in the Manaus metropolitan region.We performed a population-based cross-sectional study in 2015. Pent-up demand was based on self-report by the participants; those who reported waiting were contacted by phone to clarify the nature and reasons for the experienced delay.We interviewed 4001 adults in their households. The pent-up demand for surgical procedures in the Manaus metropolitan region was 14% (95% confidence interval: 13-15%). The surgical specialties with the highest demand included orthopedics (18.1%), gynecology (17.0%), ophthalmology (12.4%), neurosurgery (10.8%), and general surgery (10.2%). The main reason for not accessing services was their lack of availability in the public health system, leading some patients to pay for procedures in private facilities. The populations most affected by pent-up demand included elderly individuals, women, and housewives.Pent-up demand for surgical procedures is a common problem in the Manaus metropolitan region and thus requires coordinated actions to optimize access to and capacity of the healthcare system.

Health services utilization in the Brazilian Amazon: panel of two cross-sectional studies

“…The Brazilian Amazon is a heterogeneous setting where large cities coexist with relatively small and isolated villages, in which inequalities in social, economic, and health indicators are present 9 . In 2015, a population-based study in the biggest metropolitan region of the Brazilian Amazon assessed the prevalence of health services usage among adults 10,11 . Self-reported medical consultations were 77% and were higher in women, older people, and those with health insurance, whereas hospitalizations amounted to 7%, were twice as frequent in women compared with men, and thrice as frequent in those who reported very poor health status 10 .…”

“…Self-reported medical consultations were 77% and were higher in women, older people, and those with health insurance, whereas hospitalizations amounted to 7%, were twice as frequent in women compared with men, and thrice as frequent in those who reported very poor health status 10 . Unmet need for surgery affected 14% of the adults and was higher among the elderly, women, and housewives 11 .…”

Use of health services by adults in Manaus, 2019

“…[6] More than 14% of respondents reported pent-up demands of surgeries, mainly because of lack of availability in the public health system. [7] Self-medication with antibiotics was reported by a 5th of the people who used these prescription drugs in fortnight previous to interview. [8]…”