An Evaluation of The Regional Distribution of Pediatric Surgery Workforce and Surgical Load in Brazil

Abstract

ABSTRACTAimThe purpose of this study is to present data on the regional distribution of the pediatric surgical workforce and the expected local demand of pediatric operations in Brazil.MethodsWe collected data on the pediatric surgical workforce, surgical workload, GDP/capita and mortality for gastrointestinal tract malformations (MGITM) across the different regions of Brazil for 2019.FindingsData from CFM reported the existence of 1515 pediatric surgery registries in Brazil, corresponding to 1414 individual pediatric surgeons (some pediatric surgeons are registered in more than one State), or 2.4 pediatric surgeons per 100.000 children< 14 years. There were 828 male and 586 female with a M/F ratio of 1.14:1. Mean age was 51.5±12.8 years and mean time from graduation was 3,4±5,7years. Regional distribution showed a higher concentration of pediatric surgeons on the wealthier Central-West, South and Southeast regions. Individual workload ranged from 88 to 245 operations/year (average 146 operations/year) depending on the region. Only 9 (6.1%) of these were high complexity (including neonatal) operations. MGITM tended to be higher on the poorer North and Northeast regions of BrazilConclusionsWe found wide disparities in the surgical workforce and workload across Brazil, related to socioeconomic status. Areas of increased surgical workforce were associated with lower MGITM. The average number of complex operations performed yearly by the individual pediatric surgeon was considerably low. Strategic investment and definition of health policies may be needed to improve the quality of care in the different regions of Brazil.Level of EvidenceRetrospective review. Level III