Epidemiology and Estimated Cost of Brachial Plexus Surgeries Performed through the Unified Health System in Brazil (2008­2016)

Introduction The brachial plexus is responsible for the innervation of the upper extremity of the body. About 10 to 20% of the peripheral nerve lesions are brachial plexus lesions. Objective To describe the epidemiology of the brachial plexus microsurgery with exploration and neurolysis (BPMEN) and the brachial plexus microsurgery with nerve graft (BPMNG) performed through the Brazilian Unified Health System (SUS, in the Portuguese acronym) from 2008 to 2016. Methodology A descriptive epidemiological study whose data were obtained from the Department of Informatics of the SUS (Datasus, in the Portuguese acronym). The study consisted of all patients submitted to BPMEN (code: 0403020034) and to BPMNG (code: 0403020042). Result/Discussion A total of 5,295 procedures were performed with an annual incidence of 2.94/1 million inhabitants. The hospital expenses of these 2 codes totaled R$ 4,492,603.88 (US$ 1,417,225.10). The BPMNG code presented an annual average of expenses with professional services of R$ 99,732.20 (US$ 31,461.26), and total expenses of R$ 897,589.83 (US$ 283,151.36). The amount transferred to the physician in this code in 2008 was R$ 294.56 (US$ 92.92), and currently it is R$ 441.84 (US$ 139.38). The BPMEN code presented an annual average of expenses of R$ 68,579.15 (US$ 21,633.80), with total expenses of R$ 617,212.40 (US$ 194,704.22). The amount transferred to the physician in this code in 2008 was R$ 153.44 (US$ 48.40), and currently it is R$ 230.16 (US$72.60). Both codes presented a lag in the transfer values to the physician that ranged from 16.55 to 17.64% when using the Brazilian national price index for the general consumer (IPCA, in the Portuguese acronym) as an inflation parameter during the period studied. The mean number of hospitalization days for these 2 codes was 3.79. Conclusion The absence of deaths and the low rate of hospital stay confirm that the procedure is safe, with a low morbimortality rate. Both codes presented a lag in the transfer values to the physician at the end of the period.