Evidence map›Paper›PMID 42702109›Full record

ArticleClinics (Sao Paulo, Brazil)2026

Social health organizations and their role in the diffusion of minimally invasive surgery in Brazil.

Francisco Tustumi, Felipe Mendes Delpino, João Vitor Pincelli, Lucas Correa, Nelson Wolosker, Michael Anderson, Meskerem Kebede, Laia Maynou, Rachel Hargest, Rocco Friebel

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Article in Clinics (Sao Paulo, Brazil), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Francisco TustumiDepartment of Health Sciences, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil. Electronic address: francisco.tustumi@einstein.br.
Felipe Mendes DelpinoDepartment of Health Sciences, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
João Vitor PincelliDepartment of Health Sciences, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Lucas CorreaDepartment of Health Sciences, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Nelson WoloskerDepartment of Health Sciences, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Michael AndersonGlobal Surgery Policy Unit, LSE Health, London School of Economics and Political Science, London, UK.
Meskerem KebedeGlobal Surgery Policy Unit, LSE Health, London School of Economics and Political Science, London, UK.
Laia MaynouUniversitat de Barcelona, Department of Econometrics, Statistics and Applied Economics (Public Policies), Barcelona, Spain.
Rachel HargestGlobal Surgery Policy Unit, LSE Health, London School of Economics and Political Science, London, UK.
Rocco FriebelGlobal Surgery Policy Unit, LSE Health, London School of Economics and Political Science, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Brazil, Social Health Organizations (SHOs), a form of public-private partnership, manage a growing number of public hospitals. This study assessed their role in the diffusion of laparoscopic cholecystectomy.

methodsIn a nationwide study, the rates of laparoscopy were compared over time between SHO and non-SHO hospitals. We applied fixed-effects, Cox, and logistic regression models to examine the association between SHO and laparoscopy use, as well as the speed of laparoscopy adoption.

resultsOf the 2208 hospitals assessed, 83 were SHO-managed. These hospitals exhibited higher laparoscopy rates for both elective and urgent procedures. SHO hospitals had a higher likelihood of reaching ≥ 30% laparoscopy adoption earlier (HR = 2.03; 95% CI: 1.84-2.23), and they reached the adoption threshold approximately one year earlier than non-SHO hospitals (mean time to adoption: 3.7 ± 5 vs. 4.5 ± 4.7 years, respectively).

conclusionSHO-managed hospitals were associated with faster and broader adoption of laparoscopic surgery within the Brazilian public healthcare system. These findings support the potential of hybrid governance models to enhance the delivery of care in low- and middle-income settings, while acknowledging that residual confounding and selection bias cannot be fully excluded.

Indexed as

Diffusion of innovationHealth policyPublic healthPublic-private sector partnershipsTechnology transfer

Identifiers

PMID42702109
PMCPMC13579294

What OpenQuestion holds

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Registered trials

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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.