ArticleLancet regional health. Americas2021
Association between government policy and delays in emergent and elective surgical care during the COVID-19 pandemic in Brazil: a modeling study.
Article in Lancet regional health. Americas, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed.
- Intersecting harms: A structural perspective on firearm suicide among black and Latino youth in the United States.Global mental health (Cambridge, England) · 2026Review
- Access to healthcare: waiting time until the surgical procedure.Annals of medicine · 2025Article
- Total hip arthroplasty, associated rehabilitation care and the COVID-19 pandemic in France.Frontiers in health services · 2025Article
- Examining the surgical backlog due to COVID-19 in Latin America and the Caribbean: insights from a scoping review.Lancet regional health. Americas · 2024Article
- Shifts in Paediatric Road Trauma Dynamics Pre- vs. Post-COVID-19 Lockdown: Insights from a Major Trauma Centre.Journal of epidemiology and global health · 2024Article
- Frequency of splenectomy for pediatric splenic injury in Brazil: a retrospective analysis.Lancet regional health. Americas · 2024Article
- Comparative evaluation of 90-day patient outcomes and healthcare encounters following extended day surgery urethroplasty.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2023Article
- Transformative dimensions of resilience and brittleness during health systems' collapse: a case study in Brazil using the Functional Resonance Analysis Method.BMC health services research · 2023Article
- Impact of COVID-19 pandemic on surgical activity in the Brazilian private healthcare system.PloS one · 2023Article
- Patients' characteristics and 30-day mortality for those undergoing elective surgeries during the COVID-19 pandemic in Bangladesh.PloS one · 2023Article
- Minimising population health loss in times of scarce surgical capacity: a modelling study for surgical procedures performed in nonacademic hospitals.BMC health services research · 2022Article
- Elective surgeries during and after the COVID-19 pandemic: Case burden and physician shortage concerns.Annals of medicine and surgery (2012) · 2022Review
- My thoughts: Global surgery during a pandemic, a lower and middle-income country student perspective.Surgery in practice and science · 2022Article
- The disruption of elective procedures due to COVID-19 in Brazil in 2020.Scientific reports · 2022Article
- Impact of the COVID-19 pandemic on the diagnosis of leprosy in Brazil: An ecological and population-based study.Lancet regional health. Americas · 2022Article
- Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean.Frontiers in psychiatry · 2022Article
- Impact of COVID-19 Pandemic on Gynecologic Oncology Surgery in Brasil.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2021Article
- Parity of esteem: A global COVID-19 vaccination approach for people with mental illnesses, based on facts from 34 countries; recommendations and solutions.Industrial psychiatry journalArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of public health policy to reduce the spread of COVID-19 on access to surgical care is poorly defined. We aim to quantify the surgical backlog during the COVID-19 pandemic in the Brazilian public health system and determine the relationship between state-level policy response and the degree of state-level delays in public surgical care.
methodsMonthly estimates of surgical procedures performed per state from January 2016 to December 2020 were obtained from Brazil's Unified Health System Informatics Department. Forecasting models using historical surgical volume data before March 2020 (first reported COVID-19 case) were constructed to predict expected monthly operations from March through December 2020. Total, emergency, and elective surgical monthly backlogs were calculated by comparing reported volume to forecasted volume. Linear mixed effects models were used to model the relationship between public surgical delivery and two measures of health policy response: the COVID-19 Stringency Index (SI) and the Containment & Health Index (CHI) by state.
findingsBetween March and December 2020, the total surgical backlog included 1,119,433 (95% Confidence Interval 762,663-1,523,995) total operations, 161,321 (95%CI 37,468-395,478) emergent operations, and 928,758 (95%CI 675,202-1,208,769) elective operations. Increased SI and CHI scores were associated with reductions in emergent surgical delays but increases in elective surgical backlogs. The maximum government stringency (score = 100) reduced emergency delays to nearly zero but tripled the elective surgical backlog.
interpretationStrong health policy efforts to contain COVID-19 ensure minimal reductions in delivery of emergent surgery, but dramatically increase elective backlogs. Additional coordinated government efforts will be necessary to specifically address the increased elective backlogs that accompany stringent responses.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.