Congenital malformations with immediate surgery in the state of Rio de Janeiro, Brazil: analysis for organization of care in network format

This study aimed to analyze the frequency of cases, regional distribution, and analysis of the profile of healthcare establishments in which births occurred with congenital malformation that underwent immediate surgery in the state of Rio de Janeiro, Brazil. This is a descriptive study with a quantitative approach drawing on live birth databases and the national registry of healthcare establishments. The data reveal major dispersion of births with congenital malformations, in which the great majority of health units reported less than one such birth per year. These units also lack the infrastructure with potential capacity for neonatal surgical care to be performed in the same service as the birth. The persistence of this configuration of dispersion of births and structuring of healthcare services results in missed opportunities both in quality and safety and does not contribute to achieving the minimum volume of procedures per year for specialists, for empowering the results in neonatal surgical care, such as economy of scale and timely access. By analyzing and classifying units using volume of care and potential installed capacity as criteria, we identified paths for definition of referral units and organization of networks of care.