BONE MARROW ASPIRATION: ANALYSIS OF REQUESTS AND APPROVALS BETWEEN 2012 AND 2023 IN BRAZIL

Abstract

Introduction: Bone Marrow Aspiration (BMA) is a procedure used for the diagnosis of onco-hematological diseases. Currently, there is an increase in myeloproliferative diseases, which are related to harmful habits in the population, such as exposure to radical-forming products that act as aggressors to the physiology of each individual. In Brazil, BMA is associated with over 30,000 requests between 2012 and 2013, reflecting an increase in the incidence of these onco-hematological pathologies, which account for more than 15,000 diagnoses annually. Objectives: Conduct a quantitative analysis of Bone Marrow Aspiration (BMA) requests and approvals in Brazil over a 12-year period. Methodology: This is a descriptive-analytical study based on data from the “Tabnet” platform. The data obtained followed a careful retrieval process, detailed as follows: The “Tabnet” platform was accessed through DATASUS, followed by the selection of the “Health Assistance” axis and the “Ambulatory Production (SIA/SUS)” topic using the “by place of care - from 2008” option, restricting to “Geographic Coverage”, and then to “Brazil and Region by Federal Unit”. Data on “approved quantities” and “presented quantities” were extracted for the period from 2012 to 2023, focusing on the “Bone Marrow Aspiration” procedure. Results: In Brazil, over the 12-year period, a total of 395,061 Bone Marrow Aspiration (BMA) requests were observed, of which 382,356 (97%) were approved. When dividing the period into three four-year segments and analyzing the averages of the procedures, it is observed that, in the first segment (2012-2015), the overall average number of requests was 34,447.5, while approvals reached 33,757.5 (98%). In the second four-year period (2016-2019), the number of requests was 32,247, while approvals amounted to 31,494.5 (98%). In the third four-year period (2020-2023), the number of requests was 32,169, with 31,025 (96%) being approved. Thus, it is observed that from the first to the second four-year period, there was a reduction of 2,200.50 (6.4%) in requests and 2,263.00 (6.8%) in approvals. From the second to the third four-year period, the number of requests decreased by 78 (0.3%) and approvals fell by 469.5 (1.5%). Discussion: Initially, it was observed that the approval/presentation rate remained above 95% throughout the entire analyzed period. This implies that the vast majority of patients benefit from the procedure, leading to more accurate diagnoses. Consequently, patients can receive appropriate treatment and experience improved clinical outcomes. Conclusion: Thus, through this study, it was possible to clarify that bone marrow aspiration is a highly requested procedure. This highlights two scenarios expressed simultaneously. The first scenario indicates that Brazilian society is experiencing a period of increased incidence of onco-hematological diseases, and the second shows that physicians are aware of this issue and, in an effort to improve patient care, are seeking procedures aimed at earlier or faster diagnosis.