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Patterns of hospital utilization in the Unified Health System in six Brazilian capitals: comparison between the year before and the first six first months of the COVID-19 pandemic.
Portela, Margareth Crisóstomo; de Aguiar Pereira, Claudia Cristina; Lima, Sheyla Maria Lemos; de Andrade, Carla Lourenço Tavares; Martins, Mônica.
  • Portela MC; Department of Health Administration and Planning, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. mportela@ensp.fiocruz.br.
  • de Aguiar Pereira CC; Department of Health Administration and Planning, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Lima SML; Department of Health Administration and Planning, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • de Andrade CLT; Department of Health Administration and Planning, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Martins M; Department of Health Administration and Planning, Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
BMC Health Serv Res ; 21(1): 976, 2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: covidwho-1413450
ABSTRACT

OBJECTIVE:

To analyze the temporal evolution of the pattern of hospital use in the context of the COVID-19 pandemic in Brazil.

METHODS:

This retrospective observational study compared hospital use and mortality in the Brazilian Unified Health System (SUS) in the first six months of the COVID-19 pandemic with the year before the onset of the pandemic in six Brazilian capitals (São Paulo, Rio de Janeiro, Manaus, Fortaleza, Recife, and Brasilia). It was based on secondary administrative data from the SUS Hospital Information System (SIH), focusing on the number of hospitalizations per fortnight, age, and gender of patients, hospital length of stay, and the proportions of surgical, elective, with the use of ICU, and resulting in death hospitalizations. It also compared the number of hospitalizations and mortality related to frequent diagnostic groups.

RESULTS:

A significant drop was identified in the number of hospitalizations as of March 2020, with the first peak of COVID-19 hospitalizations in five capitals recorded in May 2020. In the six capitals, we observed significant reductions in the mean number of hospitalizations per fortnight from the beginning of the pandemic. We also identified an increase in the mean age of the patients and the proportion of male patients. The proportion of surgical and elective hospitalizations dropped significantly in all capitals, while the proportion of hospitalizations with ICU use increased significantly. Significant increases in-hospital mortality were also recorded in the six capitals with the pandemic, including or excluding COVID-19 hospitalizations from the comparison.

CONCLUSION:

The pandemic caused changes in the pattern of use and hospital indicators in the first six months in the cities considered, evidencing the need for attention to diseases with a hospital production altered by the COVID-19 course and health system performance problems in the face of challenges.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Pandemias / COVID-19 Tipo de estudo: Estudo experimental / Estudo observacional / Estudo prognóstico / Ensaios controlados aleatorizados Limite: Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: BMC Health Serv Res Assunto da revista: Pesquisa em Serviços de Saúde Ano de publicação: 2021 Tipo de documento: Artigo País de afiliação: S12913-021-07006-X

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Pandemias / COVID-19 Tipo de estudo: Estudo experimental / Estudo observacional / Estudo prognóstico / Ensaios controlados aleatorizados Limite: Humanos / Masculino País/Região como assunto: América do Sul / Brasil Idioma: Inglês Revista: BMC Health Serv Res Assunto da revista: Pesquisa em Serviços de Saúde Ano de publicação: 2021 Tipo de documento: Artigo País de afiliação: S12913-021-07006-X