Abstract
The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil. This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19. Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 - 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 - 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 - 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 - 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated. The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.
Highlights
Objectives: The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil
The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil’s Primary Health Care, following the onset of the COVID-19 pandemic
Considering the total rate of procedures, a significant decrease was observed in February (IRR = 0.60, 95%CI 0.55 – 0.64); this decrease was even greater in March (IRR = 0.48, 95%CI 0.45 – 0.52) and April (IRR = 0.27, 95%CI 0.25 – 0.29) and remained significant throughout the period of assessment
Summary
Since 2019, the coronavirus pandemic has changed the global picture and the organization of health services[1-4]. The problems related to the health systems’ capacity to cope with the consequences of the pandemic worldwide are well documented in the literature, and the limitations go far beyond attending to cases of the disease. The problems are related to attending to the other health demands of the population[6]. The Unified Health System in Brazil (SUS) covers almost 75% of the Brazilian population in the country, while the supplementary health care system caters to the remaining 25%. In the context of the pandemic, the System is expected to be equipped to provide assistance to the growing number of cases of COVID-19 while still attending to other acute and chronic conditions[7]. Deficiencies in Brazil’s health care networks, which are still fragmented and inadequate, the lack of coordination between health care hierarchies and underfunding as well have become even more evident during the pandemic[7,8]
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Schedule a callMore From: Revista brasileira de epidemiologia = Brazilian journal of epidemiology
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