Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19
Background: The new coronavirus disease (COVID-19) has claimed thousands of lives worldwide and disrupted the health system in many countries. As the national emergency care capacity is a crucial part of the COVID-19 response, we evaluated the Brazilian Health Care System response preparedness again...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2021.740284/full |
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| author | Lincoln Luís Silva Amanda de Carvalho Dutra Luciano de Andrade Luciano de Andrade Pedro Henrique Iora Guilherme Luiz Rodrigues Ramajo Iago Amado Peres Gualda João Felipe Hermann Costa Scheidt Pedro Vasconcelos Maia do Amaral Thiago Augusto Hernandes Rocha Catherine Ann Staton João Ricardo Nickenig Vissoci Rosilene Fressatti Cardoso |
| author_facet | Lincoln Luís Silva Amanda de Carvalho Dutra Luciano de Andrade Luciano de Andrade Pedro Henrique Iora Guilherme Luiz Rodrigues Ramajo Iago Amado Peres Gualda João Felipe Hermann Costa Scheidt Pedro Vasconcelos Maia do Amaral Thiago Augusto Hernandes Rocha Catherine Ann Staton João Ricardo Nickenig Vissoci Rosilene Fressatti Cardoso |
| author_sort | Lincoln Luís Silva |
| collection | DOAJ |
| description | Background: The new coronavirus disease (COVID-19) has claimed thousands of lives worldwide and disrupted the health system in many countries. As the national emergency care capacity is a crucial part of the COVID-19 response, we evaluated the Brazilian Health Care System response preparedness against the COVID-19 pandemic.Methods: A retrospective and ecological study was performed with data retrieved from the Brazilian Information Technology Department of the Public Health Care System. The numbers of intensive care (ICU) and hospital beds, general or intensivist physicians, nurses, nursing technicians, physiotherapists, and ventilators from each health region were extracted. Beds per health professionals and ventilators per population rates were assessed. A health service accessibility index was created using a two-step floating catchment area (2SFCA). A spatial analysis using Getis-Ord Gi* was performed to identify areas lacking access to high-complexity centers (HCC).Results: As of February 2020, Brazil had 35,682 ICU beds, 426,388 hospital beds, and 65,411 ventilators. In addition, 17,240 new ICU beds were created in June 2020. The South and Southeast regions have the highest rates of professionals and infrastructure to attend patients with COVID-19 compared with the northern region. The north region has the lowest accessibility to ICUs.Conclusions: The Brazilian Health Care System is unevenly distributed across the country. The inequitable distribution of health facilities, equipment, and human resources led to inadequate preparedness to manage the COVID-19 pandemic. In addition, the ineffectiveness of public measures of the municipal and federal administrations aggravated the pandemic in Brazil. |
| first_indexed | 2024-12-20T03:27:20Z |
| format | Article |
| id | doaj.art-de696caab0844040929d6a412972c244 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-20T03:27:20Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-de696caab0844040929d6a412972c2442022-12-21T19:55:03ZengFrontiers Media S.A.Frontiers in Public Health2296-25652021-11-01910.3389/fpubh.2021.740284740284Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19Lincoln Luís Silva0Amanda de Carvalho Dutra1Luciano de Andrade2Luciano de Andrade3Pedro Henrique Iora4Guilherme Luiz Rodrigues Ramajo5Iago Amado Peres Gualda6João Felipe Hermann Costa Scheidt7Pedro Vasconcelos Maia do Amaral8Thiago Augusto Hernandes Rocha9Catherine Ann Staton10João Ricardo Nickenig Vissoci11Rosilene Fressatti Cardoso12Graduate Program in Biosciences and Physiopathology, State University of Maringá, Paraná, BrazilGraduate Program in Health Sciences, State University of Maringá, Paraná, BrazilGraduate Program in Health Sciences, State University of Maringá, Paraná, BrazilDepartment of Medicine, State University of Maringá, Paraná, BrazilDepartment of Medicine, State University of Maringá, Paraná, BrazilDepartment of Medicine, State University of Maringá, Paraná, BrazilDepartment of Medicine, State University of Maringá, Paraná, BrazilDepartment of Medicine, State University of Maringá, Paraná, BrazilFaculty of Economic Sciences, Federal University of Minas Gerais, Belo Horizonte, BrazilGlobal Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Duke Global Health Institute, Durham, NC, United StatesGlobal Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Duke Global Health Institute, Durham, NC, United StatesGlobal Emergency Medicine Innovation and Implementation (GEMINI), Division of Emergency Medicine, Duke Global Health Institute, Durham, NC, United StatesGraduate Program in Biosciences and Physiopathology, State University of Maringá, Paraná, BrazilBackground: The new coronavirus disease (COVID-19) has claimed thousands of lives worldwide and disrupted the health system in many countries. As the national emergency care capacity is a crucial part of the COVID-19 response, we evaluated the Brazilian Health Care System response preparedness against the COVID-19 pandemic.Methods: A retrospective and ecological study was performed with data retrieved from the Brazilian Information Technology Department of the Public Health Care System. The numbers of intensive care (ICU) and hospital beds, general or intensivist physicians, nurses, nursing technicians, physiotherapists, and ventilators from each health region were extracted. Beds per health professionals and ventilators per population rates were assessed. A health service accessibility index was created using a two-step floating catchment area (2SFCA). A spatial analysis using Getis-Ord Gi* was performed to identify areas lacking access to high-complexity centers (HCC).Results: As of February 2020, Brazil had 35,682 ICU beds, 426,388 hospital beds, and 65,411 ventilators. In addition, 17,240 new ICU beds were created in June 2020. The South and Southeast regions have the highest rates of professionals and infrastructure to attend patients with COVID-19 compared with the northern region. The north region has the lowest accessibility to ICUs.Conclusions: The Brazilian Health Care System is unevenly distributed across the country. The inequitable distribution of health facilities, equipment, and human resources led to inadequate preparedness to manage the COVID-19 pandemic. In addition, the ineffectiveness of public measures of the municipal and federal administrations aggravated the pandemic in Brazil.https://www.frontiersin.org/articles/10.3389/fpubh.2021.740284/fullCOVID-19epidemiologyspatial analysispublic healthhealth services accessibility |
| spellingShingle | Lincoln Luís Silva Amanda de Carvalho Dutra Luciano de Andrade Luciano de Andrade Pedro Henrique Iora Guilherme Luiz Rodrigues Ramajo Iago Amado Peres Gualda João Felipe Hermann Costa Scheidt Pedro Vasconcelos Maia do Amaral Thiago Augusto Hernandes Rocha Catherine Ann Staton João Ricardo Nickenig Vissoci Rosilene Fressatti Cardoso Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19 Frontiers in Public Health COVID-19 epidemiology spatial analysis public health health services accessibility |
| title | Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19 |
| title_full | Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19 |
| title_fullStr | Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19 |
| title_full_unstemmed | Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19 |
| title_short | Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19 |
| title_sort | emergency care gap in brazil geographical accessibility as a proxy of response capacity to tackle covid 19 |
| topic | COVID-19 epidemiology spatial analysis public health health services accessibility |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2021.740284/full |
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