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...

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Autores principales:	Lincoln Luís Silva, Amanda de Carvalho Dutra, 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
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	COVID-19 epidemiology spatial analysis public health health services accessibility Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/de696caab0844040929d6a412972c244
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spelling	oai:doaj.org-article:de696caab0844040929d6a412972c2442021-11-16T04:47:20ZEmergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-192296-256510.3389/fpubh.2021.740284https://doaj.org/article/de696caab0844040929d6a412972c2442021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpubh.2021.740284/fullhttps://doaj.org/toc/2296-2565Background: 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.Lincoln Luís SilvaAmanda de Carvalho DutraLuciano de AndradeLuciano de AndradePedro Henrique IoraGuilherme Luiz Rodrigues RamajoIago Amado Peres GualdaJoão Felipe Hermann Costa ScheidtPedro Vasconcelos Maia do AmaralThiago Augusto Hernandes RochaCatherine Ann StatonJoão Ricardo Nickenig VissociRosilene Fressatti CardosoFrontiers Media S.A.articleCOVID-19epidemiologyspatial analysispublic healthhealth services accessibilityPublic aspects of medicineRA1-1270ENFrontiers in Public Health, Vol 9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 epidemiology spatial analysis public health health services accessibility Public aspects of medicine RA1-1270
spellingShingle	COVID-19 epidemiology spatial analysis public health health services accessibility Public aspects of medicine RA1-1270 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
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.
format	article
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
title	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_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_sort	emergency care gap in brazil: geographical accessibility as a proxy of response capacity to tackle covid-19
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/de696caab0844040929d6a412972c244
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Emergency Care Gap in Brazil: Geographical Accessibility as a Proxy of Response Capacity to Tackle COVID-19

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