MR Tovani-Palone, A Formenton, SR Bertolini

Abstract

Objective: To investigate the existence of regionalisation of high complexity surgeries and decentralisation of outpatient treatment services for cleft lip and/or palate linked to the Brazilian Unified Health System (Sistema Único de Saúde - SUS) and/or of philanthropic nature in the state of São Paulo, Brazil, during the period between 2000 and 2015. Methods: This was a descriptive and comparative study, comprising searches on the National Register of Health Establishments, National Register of Associations of the PROFIS Network, free access sites and documents on the Internet. Further data were obtained from the Department of Informatics of SUS, by searching with the corresponding codes for surgical treatments of cleft lip and/or palate. Results: According to the National Register of Health Establishments, there are nine centres accredited as specialised in the high complexity treatment for cleft lip and/or palate throughout the state of São Paulo, located in eight cities. Six new centres have been accredited since 2000. Overall, there are 13 associations in the state, and two associations were created in the last 15 years. There is only one nucleus directed to cleft lip and/or palate. Among accredited establishments, a much larger number of Authorisations of Hospital Internment approved for performing high complexity surgeries was observed to the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo. Conclusion: There are indications of centralisation of high complexity surgeries for the treatment of cleft lip and/or palate, while a trend toward decentralisation was observed for outpatient services.