{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:28:48Z","timestamp":1774243728156,"version":"3.50.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Elective procedures were temporarily suspended several times over the course of the pandemic of COVID-19. Monthly data from the Unified Health System (SUS) were used for the period between January 2008 and December 2020 and the interrupted time series method was used to estimate the effect of the pandemic on the number of elective surgeries and elective procedures that were not performed. Considering a 9-month period, a reduction of 46% in the number of elective procedures carried out in the SUS could be attributed to COVID-19, corresponding to about 828,429 elective procedures cancelled, ranging from 549,921 to 1,106,936. To a full recovery of pre-pandemic performance, SUS would need to increase about 21,362 hospital beds, ranging from 12,370 to 36,392 hospital beds during a 6\u00a0month-period. This effort would represent an increase of 8.48% (ranging from 4.91 to 14.45%) in relation to the total number of SUS\u2019s hospital beds in 2019. As a result, the pandemic will leave a large number of elective procedures to be carried out, which will require efforts by health agencies to meet this demand.<\/jats:p>","DOI":"10.1038\/s41598-022-13746-5","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T11:07:45Z","timestamp":1656500865000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The disruption of elective procedures due to COVID-19 in Brazil in 2020"],"prefix":"10.1038","volume":"12","author":[{"given":"Gustavo Saraiva","family":"Frio","sequence":"first","affiliation":[]},{"given":"Let\u00edcia Xander","family":"Russo","sequence":"additional","affiliation":[]},{"given":"Cleandro Pires","family":"de Albuquerque","sequence":"additional","affiliation":[]},{"given":"Licia Maria Henrique","family":"da Mota","sequence":"additional","affiliation":[]},{"given":"Adriana Ferreira","family":"Barros-Areal","sequence":"additional","affiliation":[]},{"given":"Andr\u00e9a Pedrosa Ribeiro Alves","family":"Oliveira","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"Firmino-Machado","sequence":"additional","affiliation":[]},{"given":"Everton Nunes","family":"da Silva","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"issue":"17","key":"13746_CR1","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1001\/jama.2020.19594","volume":"324","author":"JW Meredith","year":"2020","unstructured":"Meredith, J. W., High, K. P. & Freischlag, J. A. Preserving elective surgeries in the COVID-19 pandemic and the future. JAMA 324(17), 1725\u20131726. https:\/\/doi.org\/10.1001\/jama.2020.19594 (2020).","journal-title":"JAMA"},{"issue":"11","key":"13746_CR2","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1002\/bjs.11746","volume":"107","author":"COVIDSurg Collaborative","year":"2020","unstructured":"COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: Global predictive modelling to inform surgical recovery plans. Br. J. Surg. 107(11), 1440\u20131449. https:\/\/doi.org\/10.1002\/bjs.11746 (2020).","journal-title":"Br. J. Surg."},{"issue":"3","key":"13746_CR3","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1016\/j.jvs.2020.08.036","volume":"73","author":"NJ Mouawad","year":"2021","unstructured":"Mouawad, N. J. et al. The impact of the COVID-19 pandemic on vascular surgery practice in the United States. J. Vasc. Surg. 73(3), 772-779.e4. https:\/\/doi.org\/10.1016\/j.jvs.2020.08.036 (2021).","journal-title":"J. Vasc. Surg."},{"issue":"1","key":"13746_CR4","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1186\/s13018-021-02286-9","volume":"16","author":"T-F Lou","year":"2021","unstructured":"Lou, T.-F., Ren, Z., Sun, Z.-H., Wang, W. & Fan, C.-Y. Full recovery of elective orthopedic surgery in the age of COVID-19: An 8-month retrospective cohort study. J. Orthop. Surg. Res. 16(1), 154. https:\/\/doi.org\/10.1186\/s13018-021-02286-9 (2021).","journal-title":"J. Orthop. Surg. Res."},{"issue":"3","key":"13746_CR5","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.21873\/invivo.12386","volume":"35","author":"P Blum","year":"2021","unstructured":"Blum, P., Putzer, D., Liebensteiner, M. C. & Dammerer, D. Impact of the Covid-19 pandemic on orthopaedic and trauma surgery\u2014A systematic review of the current literature. In Vivo 35(3), 1337\u20131343. https:\/\/doi.org\/10.21873\/invivo.12386 (2021).","journal-title":"In Vivo"},{"issue":"2","key":"13746_CR6","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(21)00001-1","volume":"3","author":"The Lancet Rheumatology","year":"2021","unstructured":"The Lancet Rheumatology. Too long to wait: The impact of COVID-19 on elective surgery. Lancet Rheumatol. 3(2), e83. https:\/\/doi.org\/10.1016\/S2665-9913(21)00001-1 (2021).","journal-title":"Lancet Rheumatol."},{"issue":"6","key":"13746_CR7","doi-asserted-by":"publisher","first-page":"e782","DOI":"10.1016\/S2214-109X(21)00081-4","volume":"9","author":"R Rocha","year":"2021","unstructured":"Rocha, R. et al. Effect of socioeconomic inequalities and vulnerabilities on health-system preparedness and response to COVID-19 in Brazil: A comprehensive analysis. Lancet Glob. Health 9(6), e782\u2013e792. https:\/\/doi.org\/10.1016\/S2214-109X(21)00081-4 (2021).","journal-title":"Lancet Glob. Health"},{"key":"13746_CR8","unstructured":"WHO WHO. Coronavirus (COVID-19) dashboard. https:\/\/covid19.who.int\/. Published 2021. Accessed 9 April 2021."},{"issue":"5","key":"13746_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(21)00095-1","volume":"2","author":"T Burki","year":"2021","unstructured":"Burki, T. No end in sight for the Brazilian COVID-19 crisis. Lancet Microbe 2(5), e180. https:\/\/doi.org\/10.1016\/S2666-5247(21)00095-1 (2021).","journal-title":"Lancet Microbe"},{"issue":"4","key":"13746_CR10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-000829","volume":"3","author":"A Massuda","year":"2018","unstructured":"Massuda, A., Hone, T., Leles, F. A. G., de Castro, M. C. & Atun, R. The Brazilian health system at crossroads: Progress, crisis and resilience. BMJ Glob. Health 3(4), e000829. https:\/\/doi.org\/10.1136\/bmjgh-2018-000829 (2018).","journal-title":"BMJ Glob. Health"},{"issue":"6","key":"13746_CR11","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1590\/1413-81232018236.09172018","volume":"23","author":"JS Paim","year":"2018","unstructured":"Paim, J. S. Thirty years of the Unified Health System (SUS). Cien Saude Colet. 23(6), 1723\u20131728. https:\/\/doi.org\/10.1590\/1413-81232018236.09172018 (2018).","journal-title":"Cien Saude Colet."},{"issue":"6544","key":"13746_CR12","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1126\/science.abh1558","volume":"372","author":"MC Castro","year":"2021","unstructured":"Castro, M. C. et al. Spatiotemporal pattern of COVID-19 spread in Brazil. Science 372(6544), 821\u2013826. https:\/\/doi.org\/10.1126\/science.abh1558 (2021).","journal-title":"Science"},{"issue":"1","key":"13746_CR13","first-page":"111","volume":"49","author":"JR Alves","year":"2020","unstructured":"Alves, J. R. Recomenda\u00e7\u00f5es em cirurgia durante a pandemia da Covid-19. Arq Catarinenses Med. 49(1), 111\u2013125 (2020).","journal-title":"Arq Catarinenses Med."},{"key":"13746_CR14","unstructured":"Brasil M da S. Declara, em todo o territ\u00f3rio nacional, o estado de transmiss\u00e3o comunit\u00e1ria do coronav\u00edrus (covid-19). PORTARIA No 454, DE 20 DE MAR\u00c7O DE 2020. https:\/\/www.in.gov.br\/en\/web\/dou\/-\/portaria-n-454-de-20-de-marco-de-2020-249091587. Published 2020."},{"key":"13746_CR15","unstructured":"Brasil M da S. Cadastro Nacional de Estabelecimentos de Sa\u00fade. CNES. http:\/\/cnes.datasus.gov.br\/"},{"key":"13746_CR16","unstructured":"IBGE IB de G e E. Proje\u00e7\u00e3o da popula\u00e7\u00e3o por sexo e grupos de idade, em 1o de julho\u20142000\/2060. Proje\u00e7\u00f5es da Popula\u00e7\u00e3o. https:\/\/www.ibge.gov.br\/estatisticas\/sociais\/populacao\/9109-projecao-da-populacao.html?=&t=o-que-e"},{"issue":"2","key":"13746_CR17","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1177\/1536867X1501500208","volume":"15","author":"A Linden","year":"2015","unstructured":"Linden, A. Conducting interrupted time-series analysis for single- and multiple-group comparisons. Stata J. 15(2), 480\u2013500. https:\/\/doi.org\/10.1177\/1536867X1501500208 (2015).","journal-title":"Stata J."},{"issue":"1","key":"13746_CR18","doi-asserted-by":"publisher","first-page":"185","DOI":"10.2307\/2951684","volume":"60","author":"RE Cumby","year":"1992","unstructured":"Cumby, R. E. & Huizinga, J. Testing the autocorrelation structure of disturbances in ordinary least squares and instrumental variables regressions. Econometrica 60(1), 185\u2013195. https:\/\/doi.org\/10.2307\/2951684 (1992).","journal-title":"Econometrica"},{"key":"13746_CR19","doi-asserted-by":"publisher","DOI":"10.1596\/978-0-8213-9843-2","volume-title":"Twenty Years of Health System Reform in Brazil: An Assessment of the Sistema \u00danico de Sa\u00fade","author":"M Gragnolati","year":"2013","unstructured":"Gragnolati, M., Lindelow, M., Lindel\u00f6w, M. & Couttolenc, B. Twenty Years of Health System Reform in Brazil: An Assessment of the Sistema \u00danico de Sa\u00fade 1st edn. (World Bank Publications, 2013). https:\/\/doi.org\/10.1596\/978-0-8213-9843-2.","edition":"1"},{"key":"13746_CR20","doi-asserted-by":"publisher","DOI":"10.1101\/2021.03.17.21253801","author":"BO Luizeti","year":"2021","unstructured":"Luizeti, B. O. et al. Impact of the COVID-19 pandemic on surgical procedures in Brazil: A descriptive study. medRxiv https:\/\/doi.org\/10.1101\/2021.03.17.21253801 (2021).","journal-title":"medRxiv"},{"issue":"1","key":"13746_CR21","doi-asserted-by":"publisher","DOI":"10.1590\/S1679-49742021000100016","volume":"30","author":"AYCC de Ara\u00fajo","year":"2020","unstructured":"de Ara\u00fajo, A. Y. C. C., de Almeida, E. R. B., Lima, L. K., de Sandes-Freitas, T. V. & Pinto, A. G. A. Decl\u00ednio nas doa\u00e7\u00f5es e transplantes de \u00f3rg\u00e3os no Cear\u00e1 durante a pandemia da COVID-19: Estudo descritivo, abril a junho de 2020. Epidemiol e Servi\u00e7os Sa\u00fade. 30(1), e2020754. https:\/\/doi.org\/10.1590\/S1679-49742021000100016 (2020).","journal-title":"Epidemiol e Servi\u00e7os Sa\u00fade."},{"key":"13746_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2021.100056","volume":"3","author":"P Truche","year":"2021","unstructured":"Truche, P. et al. Association between government policy and delays in emergent and elective surgical care during the COVID-19 pandemic in Brazil: A modeling study. Lancet Reg. Health Am. 3, 100056. https:\/\/doi.org\/10.1016\/j.lana.2021.100056 (2021).","journal-title":"Lancet Reg. Health Am."},{"issue":"10321","key":"13746_CR23","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/S0140-6736(21)02836-1","volume":"399","author":"D Nepogodiev","year":"2022","unstructured":"Nepogodiev, D. et al. Projecting COVID-19 disruption to elective surgery. Lancet 399(10321), 233\u2013234. https:\/\/doi.org\/10.1016\/S0140-6736(21)02836-1 (2022).","journal-title":"Lancet"},{"issue":"4","key":"13746_CR24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-054110","volume":"12","author":"MM Rovers","year":"2022","unstructured":"Rovers, M. M. et al. Development of a decision analytical framework to prioritise operating room capacity: Lessons learnt from an empirical example on delayed elective surgeries during the COVID-19 pandemic in a hospital in the Netherlands. BMJ Open 12(4), e054110. https:\/\/doi.org\/10.1136\/bmjopen-2021-054110 (2022).","journal-title":"BMJ Open"},{"issue":"1","key":"13746_CR25","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1186\/s12913-021-06492-3","volume":"21","author":"M Deschepper","year":"2021","unstructured":"Deschepper, M. et al. Prediction of hospital bed capacity during the COVID-19 pandemic. BMC Health Serv. Res. 21(1), 468. https:\/\/doi.org\/10.1186\/s12913-021-06492-3 (2021).","journal-title":"BMC Health Serv. Res."},{"issue":"3","key":"13746_CR26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034253","volume":"10","author":"TAH Rocha","year":"2020","unstructured":"Rocha, T. A. H. et al. Towards defining the surgical workforce for children: A geospatial analysis in Brazil. BMJ Open 10(3), e034253. https:\/\/doi.org\/10.1136\/bmjopen-2019-034253 (2020).","journal-title":"BMJ Open"},{"issue":"2","key":"13746_CR27","doi-asserted-by":"publisher","DOI":"10.5123\/S1679-49742020000200020","volume":"29","author":"LT Campoy","year":"2020","unstructured":"Campoy, L. T. et al. A distribui\u00e7\u00e3o espacial e a tend\u00eancia temporal de recursos humanos para o Sistema \u00danico de Sa\u00fade e para a Sa\u00fade Suplementar, Brasil, 2005 a 2016. Epidemiol e Servi\u00e7os Sa\u00fade. 29(2), e2018376 (2020).","journal-title":"Epidemiol e Servi\u00e7os Sa\u00fade."},{"issue":"10195","key":"13746_CR28","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/S0140-6736(19)31243-7","volume":"394","author":"MC Castro","year":"2019","unstructured":"Castro, M. C. et al. Brazil\u2019s unified health system: The first 30 years and prospects for the future. Lancet (London, England). 394(10195), 345\u2013356. https:\/\/doi.org\/10.1016\/S0140-6736(19)31243-7 (2019).","journal-title":"Lancet (London, England)."},{"issue":"6","key":"13746_CR29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.31487\/j.COR.2020.06.05","volume":"3","author":"D Garcia","year":"2020","unstructured":"Garcia, D. et al. What is elective oncologic surgery in the time of COVID-19? A literature review of the impact of surgical delays on outcomes in patients with cancer. Clin. Oncol. Res. 3(6), 1\u201311. https:\/\/doi.org\/10.31487\/j.COR.2020.06.05 (2020).","journal-title":"Clin. Oncol. Res."},{"key":"13746_CR30","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1186\/1471-2458-7-164","volume":"7","author":"JP Oudhoff","year":"2007","unstructured":"Oudhoff, J. P., Timmermans, D. R. M., Knol, D. L., Bijnen, A. B. & van der Wal, G. Waiting for elective general surgery: Impact on health related quality of life and psychosocial consequences. BMC Public Health 7, 164. https:\/\/doi.org\/10.1186\/1471-2458-7-164 (2007).","journal-title":"BMC Public Health"},{"issue":"6","key":"13746_CR31","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000000855","volume":"5","author":"AF Cisternas","year":"2020","unstructured":"Cisternas, A. F., Ramachandran, R., Yaksh, T. L. & Nahama, A. Unintended consequences of COVID-19 safety measures on patients with chronic knee pain forced to defer joint replacement surgery. Pain Rep. 5(6), e855. https:\/\/doi.org\/10.1097\/PR9.0000000000000855 (2020).","journal-title":"Pain Rep."},{"issue":"5","key":"13746_CR32","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1445-1433.2004.02998.x","volume":"74","author":"JP Oudhoff","year":"2004","unstructured":"Oudhoff, J. P., Timmermans, D. R. M., Bijnen, A. B. & van der Wal, G. Waiting for elective general surgery: Physical, psychological and social consequences. ANZ J. Surg. 74(5), 361\u2013367. https:\/\/doi.org\/10.1111\/j.1445-1433.2004.02998.x (2004).","journal-title":"ANZ J. Surg."},{"issue":"12","key":"13746_CR33","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1038\/s41562-020-01009-0","volume":"4","author":"N Haug","year":"2020","unstructured":"Haug, N. et al. Ranking the effectiveness of worldwide COVID-19 government interventions. Nat. Hum. Behav. 4(12), 1303\u20131312. https:\/\/doi.org\/10.1038\/s41562-020-01009-0 (2020).","journal-title":"Nat. Hum. Behav."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-13746-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-13746-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-13746-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T06:34:43Z","timestamp":1669358083000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-13746-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,29]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["13746"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-13746-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,29]]},"assertion":[{"value":"28 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"10942"}}