Traveling for Sleep: The Uneven Landscape of Sleep Disorder Diagnostics in Brazil’s Public Healthcare System
Author(s)
Douglas G. Silva, Spec.1, Beny Finkelstein, MBA2.
1Health Economics, Autonomous, São Paulo, Brazil, 2Autonomous, São Paulo, Brazil.
1Health Economics, Autonomous, São Paulo, Brazil, 2Autonomous, São Paulo, Brazil.
OBJECTIVES: Polysomnography (PSG) type 1 is available in the Brazilian Public Healthcare System (SUS) and his availability remain a challenge, increasing access barriers to diagnostic and treatment. This research aims to consolidate and explore sleep disorders related to PSGs landscape scenario in SUS.
METHODS: Open data from Ministry of Health Informatic Department of SUS (DATASUS) with hospital (SIH) and ambulatory (SIA) admissions, from 2008 to 2023 with a PSG code associated with the G47 ICD. Unique ID procedures were identified to analyze center’s geographics, characteristics and procedures availability growth overtime.
RESULTS: In the period, 121,801 PSGs funded by SUS were performed in 170 institutions, 62% public and 38% private, respectively responsible for 75% and 25% of overall procedures. Gender was identified in 68% of procedures, being 70% male and 30% female. The number of institutions has increased from 11 in 2008 to 113 in 2023 (927% growth), and from 6.4 thousand procedures per year in 2008 to 16.6 thousand in 2023, meaning 123% growth in procedures performed. 70% of overall procedures were concentrated in state capital cities. From 27 states, 7 haven’t had any PSGs funded by SUS. Patients had to travel from their residential city to the institution city in 40% of all procedures registered.
CONCLUSIONS: The real-world evidence demonstrates that while the availability of PSG centers has grown significantly over the past 15 years, access remains highly capital centralized, forcing patients to travel among cities to have access. Many regions still lack publicly funded diagnostic centers, forcing patients to travel long distances for care. The slow increase in procedure volume highlights ongoing barriers to timely diagnosis and equitable access. These findings underscore the urgent need for targeted policies to decentralize and leverage telehealth to expand sleep disorders diagnostic services, ensuring broader and more equitable access for all patients across the country.
METHODS: Open data from Ministry of Health Informatic Department of SUS (DATASUS) with hospital (SIH) and ambulatory (SIA) admissions, from 2008 to 2023 with a PSG code associated with the G47 ICD. Unique ID procedures were identified to analyze center’s geographics, characteristics and procedures availability growth overtime.
RESULTS: In the period, 121,801 PSGs funded by SUS were performed in 170 institutions, 62% public and 38% private, respectively responsible for 75% and 25% of overall procedures. Gender was identified in 68% of procedures, being 70% male and 30% female. The number of institutions has increased from 11 in 2008 to 113 in 2023 (927% growth), and from 6.4 thousand procedures per year in 2008 to 16.6 thousand in 2023, meaning 123% growth in procedures performed. 70% of overall procedures were concentrated in state capital cities. From 27 states, 7 haven’t had any PSGs funded by SUS. Patients had to travel from their residential city to the institution city in 40% of all procedures registered.
CONCLUSIONS: The real-world evidence demonstrates that while the availability of PSG centers has grown significantly over the past 15 years, access remains highly capital centralized, forcing patients to travel among cities to have access. Many regions still lack publicly funded diagnostic centers, forcing patients to travel long distances for care. The slow increase in procedure volume highlights ongoing barriers to timely diagnosis and equitable access. These findings underscore the urgent need for targeted policies to decentralize and leverage telehealth to expand sleep disorders diagnostic services, ensuring broader and more equitable access for all patients across the country.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR223
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health Disparities & Equity, Public Spending & National Health Expenditures
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)