Abstract
ABSTRACT The study aims to investigate the flows of Covid-19 hospitalizations in the 450 Brazilian health regions and 117 health macro-regions between March and October 2020. This descriptive study includes all Covid-19 hospitalizations registered in the Influenza Epidemiological Surveillance Information System between the eighth and forty-fourth epidemiological weeks of 2020. In Brazil, 397,830 admissions were identified for Covid-19. Emigration was 11.9% for residents in health regions and 6.8% in macro-regions; this pattern was also maintained during the peak period of Covid-19 hospitalizations. The average evasion for residents of health regions was 17.6% in the Northeast and 8.8% in the South. Evasion was more accentuated in health regions with up to 100 thousand inhabitants(36.9%), which was 7 times greater than that observed in health regions with more than 2 million inhabitants (5.2%). The negative migratory efficacy indicator (-0.39) revealed a predominance of evasion. Of the 450 Brazilian health regions, 117 (39.3%) had a coefficient of migratory efficacy between-1 and-0.75, and 113 (25.1%) between-0.75 and-0.25. Results indicate that the regionalization of the health system exhibited adequate organization of healthcare in the territory; however, the long distances traveled are still worrisome.
Highlights
Worldwide, Covid-19 has challenged health systems, which needed to reorganize health services to face the pandemic[1,2]
In the period from March to October 2020, 397,830 hospitalizations were registered in Brazil due Covid-19, being: 33,399 in the North (8.4%, rate of 17.9 hospitalizations per 10,000 inhab.); 37,626 in the Central-west (9.4%, rate of 22.8 admissions per 10,000 inhab.); 45,187 in the South (11.4%, rate of 15 admissions per 10,000 inhab.); 81,121 in the Northeast (20.4%, rate of 14.1 admissions per 10 thousand inhabitants); and 200,497 in the Southeast (50.4%, rate of 22.5 hospitalizations per 10,000 inhab.)
The study results revealed a low percentage of evasion for hospitalization by Covid-19 in the Brazilian health regions (11.9%) and in the Brazilian health macro-regions (6.8%), and demonstrated the centrality exercised by state capitals
Summary
Covid-19 has challenged health systems, which needed to reorganize health services to face the pandemic[1,2]. United States, India and Brazil are the countries with the highest number of cases and deaths from Covid-19. It has negative consequences around the world, in developing countries, Covid-19 is more likely to increase health inequities, including failures in access to health care and increased flow of patients for health treatment[3]. In addition to socioeconomic differences, an unequal distribution of resources and provision of health services – In addition to changing the flow of patients – have an impact on well-being, morbidity and mortality from the disease[4,5]
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