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.

目的：就2000年至2015年期間在巴西聯合健康系統或／和巴西聖保羅州立慈善機構登記的唇裂和／或伴齶裂，對進行高複雜性手術的區域化和門診病人治療服務分散設立在不同地區的情況進行調查。方法：本研究為分類和比較性，互聯網免費網址和記錄範圍包括國家健康基本登記系統、國家PROFIS網組織登記中心。其他資料來自 SUS資料部門，以相應代碼查詢唇裂和齶裂手術治療情況。結果：根據國家基本健康登記系統，聖保羅州認證的專門進行唇裂和齶裂高難度手術中心有9個，位於8個城市中。2000年後認證的新中心有6個。州內組織共13 個，其中2個成立於近15年。唇裂齶裂主導核心僅有1個。獲得認證的機構中，聖保羅大學頭面畸形康復醫院，得到醫院內部管理部門批准的高難度唇裂齶裂手術數量特別大。結論：資料顯示高難度的唇裂齶裂手術治療呈現中心化，而門診服務則分散設立在不同地區的趨勢。