Abstract
BackgroundThe organisation and systematisation of health actions and services are essential to ensure patient safety and the effectiveness and efficiency of cancer care. The objective of this study was to analyse the structure of cancer care envisaged in Brazilian norms, describe the types of accreditations of cancer services and their geographic distribution, and determine the planning and evaluation parameters used to qualify the health units that provide cancer care in Brazil.MethodsThis observational study identified the current organisation of cancer care and other health services that are accredited by Brazil’s national health system (SUS) for cancer treatment as of February 2017. The following information was collected from the current norms and the National Registry of Health Establishments: geographic location, type of accreditation, type of care, and hospital classification according to annual data of the number of cancer surgeries. The adequacy of the number of licensed units relative to population size was assessed. The analysis considered the facilitative or restrictive nature of policies based on the available rules and resources.ResultsThe analysis of the norms indicated that these documents serve as structuring rules and resources for developing and implementing cancer care policies in Brazil. A total of 299 high-complexity oncology services were identified in facilities located in 173 (3.1%) municipalities. In some states, there were no authorised services in radiotherapy, paediatric oncology and/or haematology-oncology. There was a significant deficit in accredited oncology services.ConclusionsThe parameters that have been used to assess the need for accredited cancer services in Brazil are widely questioned because the best basis of calculation is the incidence of cancer or disease burden rather than population size. The results indicate that the availability of cancer services is insufficient and the organisation of the cancer care network needs to be improved in Brazil.
Highlights
The organisation and systematisation of health actions and services are essential to ensure patient safety and the effectiveness and efficiency of cancer care
This observational study identified the current norms for the organisation of cancer care and of all health services accredited by the Unified Health System (SUS) for cancer treatment in February 2017
The analysis of the norms indicated that these documents served as structuring rules and resources for developing and implementing cancer care policies in Brazil
Summary
The organisation and systematisation of health actions and services are essential to ensure patient safety and the effectiveness and efficiency of cancer care. Cancer is a group of diseases of multifactorial origin with increasing worldwide incidence and mortality, necessitating intersectional actions for its control when there are limited financial resources [1]. There are large gaps in cancer treatment outcomes because of differences among countries in socioeconomic development and access to health services [3]. A fundamental mechanism for ensuring patient safety and the According to the International Agency for Research on Cancer (IARC), in 2018 the estimated global incidence of cancer was 18.1 million cases, and the estimated mortality from cancer was 9.6 million people [1]. From the beginning of the twentieth century to 1937, cancer care in Brazil was largely absorbed by philanthropic institutions.
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