Cancer care network: Structure analysis of enabled services.

Abstract

Cancer has now become part of the agenda of health managers, prompting them to consider new models of system organization. To study the cancer care network of the Brazilian public health system (SUS, in the Portuguese acronym) in the state of São Paulo by analyzing the structure of the installed and enabled network for treatment and its characteristics. A single, integrated case study. We used secondary data from the following sources: Datasus, Inca, RHC and CNES, and primary data from official documents from the Reference Committee on Oncology of the State of Sao Paulo. We used the official guidelines to able services from the National Health Department to make comparison. According to the CNES, in April, 2013 there were 72 cancer care services authorized by SUS in the state of Sao Paulo. Using the population criterion, the state had one service enabled for every 581,961 inhabitants, in an unequal distribution throughout the 17 health care regions. In terms of available structure and services, 80% of the hospitals were compliant for cancer surgery, 31% for chemotherapy and 74% for radiotherapy. In terms of minimum production, only 13% of hospitals were compliant with cancer surgery, 42% with chemotherapy and 14% with radiotherapy. The installed network proved to have sufficient size and structure to meet the demand from new cancer cases. However, there were both regional differences, as well as a wide variation in productivity between services, which probably had an impact on patient access.