New Endometriosis Study Findings Reveal Treatment Pathways in Brazil’s Largest Private Health Insurance
A recent study published in PLOS ONE provides the first real-world analysis of endometriosis treatment pathways within Brazil’s largest private health insurance system, offering critical insights into clinical characteristics, diagnostic timelines, surgical outcomes and cost burdens for affected women.
Study Overview and Methodology
Conducted by researchers from the International Research and Teaching Institute, Hapvida NotreDame, Ninth of July University School of Medicine, and Federal University of São Paulo School of Medicine, the study analyzed data from over 8.8 million lives in the Hapvida NotreDame portfolio. The retrospective cohort included 5,740 women who underwent their first surgical procedure for endometriosis between 2006 and 2024.
The research focused on clinical and demographic characteristics, diagnostic timelines, treatment outcomes, and healthcare utilization patterns for women receiving surgical treatment for endometriosis within Brazil’s largest healthcare database.
Key Findings on Patient Characteristics and Diagnosis
The cohort had a median surgical age of 37 years. Notably, patients with deep endometriosis experienced longer delays in undergoing surgery compared to those with superficial endometriosis, highlighting disparities in timely access to care based on disease severity.
Surgical Outcomes and Postoperative Care
Following surgery, the study observed an increase in both normal deliveries and cesarean sections, alongside a decrease in emergency gynecological consultations, suggesting potential improvements in reproductive health outcomes and reduced acute care needs post-intervention.
The median hospital stay for endometriosis surgery was just one day, indicating efficient perioperative management. Only 66 patients (1.1%) required postoperative intensive care unit admission, and 93 patients (1.6%) needed early reoperation. Disease recurrence requiring further surgery occurred in 239 patients (4.1%) during the study period.
Cost Analysis Reveals Significant Disease Burden
Surgery for deep endometriosis was found to be 40% more expensive than for superficial endometriosis. The cost of diagnostic exams for endometriosis amounted to 69% of the cost of the first surgical procedure, underscoring the substantial financial burden associated with both diagnosis and treatment of the condition.
Implications for Clinical Practice and Policy
This landmark study provides essential real-world evidence on endometriosis care in a major private health insurance setting in Brazil. The findings emphasize the need for earlier diagnosis—particularly for deep endometriosis—to reduce surgical delays and associated costs. The data also support the value of surgical intervention in improving long-term reproductive outcomes and reducing emergency healthcare utilization.
By identifying disparities in treatment timelines and highlighting the economic impact of diagnostic and therapeutic pathways, the study offers actionable insights for clinicians, healthcare administrators, and policymakers aiming to improve endometriosis care delivery and resource allocation in similar healthcare systems.
Source: Rodrigo Afonso da Silva Sardenberg, Jose Arnaldo Shiomi da Cruz, Carlos Augusto Lima de Campos, Breno Cordeiro Porto, Kenneth Almeida. “Endometriosis treatment pathways in the largest private health insurance in Brazil: A real-world data study.” PLOS ONE. Published April 10, 2026. DOI: 10.1371/journal.pone.0345399.