Access to healthcare: waiting time until the surgical procedure

Abstract

Background: Understanding the determinants that limit the population’s access to surgical care in health services is highly relevant in order to provide data to support political interventions. Objective: This study aimed to evaluate the time between diagnosis and elective surgery in adult patients with the longest waiting lists in Brazil; identify the determinants that interfere with access to the health service to perform surgery; and analyze the quality of life after the indicative diagnosis of surgical intervention. Methods: A cross-sectional study was conducted with adult patients treated at three hospitals in the Southeast, North and South regions of Brazil, from October 2020 to October 2022. Data collection included socio-demographic data and assessment of quality of life using the WHOQOL-Bref instrument in the immediate postoperative period and one month after surgery. Results: A total of 250 patients participated in the study, 55.6% patients from the Southeast, 20.4% patients from the North and 24% patients from the South, with a mean age of 51.86 (SD = 14.27) years and clinical history such as arterial hypertension (p < 0.001). The longest mean waiting time for surgery identified was 26.23 (SD = 17.62) months in the South region, with a significant difference between the evaluated institutions (p = 0.02). Differences were observed between the first place of care of the evaluated patients (p < 0.001). There was a difference in the perception of quality of life between the immediate and late postoperative periods (p = 0.007) and in the physical domain, with an increase in scores among older patients (p = 0.004) and previous clinical history (p = 0.03). Conclusion: Access to the health system varies by region and does not meet the standards proposed by the Brazilian health system. In addition, it seems that longer waiting times for surgery more perceptibly affect the quality of life of older adults and those with other associated diseases.