Direct cost of trabeculectomy in the Brazilian public health system: a micro-costing analysis in a university hospital.

Single-center analysis at one Brazilian university hospital, so results may not apply to other services or countries. Only direct intraoperative materials and medications were counted; staff time, sterilization, equipment, energy, and administration were excluded. Records were paper-based and secondary, and incomplete or combined surgeries were excluded, so some clinical detail and cost components may be missing. The study compared costs with amounts actually billed and approved, not with the nominal public payment table, and the payment components were not transparent. No patient outcomes, surgical complications, or effectiveness of nursing workflow changes were measured. Waiting time and access indicators were described alongside costs, but no causal relationship was tested.

Do not read the positive reimbursement difference as proof that trabeculectomy is fully cost-effective or that supply savings alone will shorten waiting lists. The analysis counted only direct intraoperative materials and medications, excluded indirect and structural costs, and was limited to one Brazilian university hospital.