Abstract

BackgroundAccess to the diagnosis and treatment of breast cancer in Brazil is marked by immense inequalities in the provision of specialized assistance, which leads patients to seek treatment outside the place of residence. To evaluate the variations between 2004 and 2014 in the distribution of flow between place of residence and care, and the average distance traveled for treatment of breast cancer in the administrative regions and federal states of Brazil.MethodAnalysis of secondary data from the years 2004 and 2014, extracted from the Department of Informatics of the Unified Health System through the Hospital Information System. Data from Hospitalization Release Authorizations were collected, and the maps were created with TabWin 3.6 software. Descriptive analysis was performed on Stata® (StataCorp, LC) 11.0.ResultsIn the total flow, it was observed that there was a decrease in referrals between 2004 and 2014 in most regions. In 2004 the main direction of flow was in the Midwest and Southeast regions. In 2014, however, the intensity of these admissions was centralized in the Southeast region. In relation to the average distance traveled, the North, Northeast, and Midwest regions had the highest values of displacement. Of the 27 federative units, 17 presented an increase in average distance between these periods.ConclusionDespite the improvement in the hospitalization of residents, in most regions and federal units, Brazilians still travel great distances when they require treatment for breast cancer.

Highlights

  • Access to the diagnosis and treatment of breast cancer in Brazil is marked by immense inequalities in the provision of specialized assistance, which leads patients to seek treatment outside the place of residence

  • In 2014, the intensity of these admissions was centralized in the Southeast region

  • In 2014, the intensity of these admissions was centralized in the Southeast, the region that admitted the most patients from other geographical units

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Summary

Introduction

Access to the diagnosis and treatment of breast cancer in Brazil is marked by immense inequalities in the provision of specialized assistance, which leads patients to seek treatment outside the place of residence. To evaluate the variations between 2004 and 2014 in the distribution of flow between place of residence and care, and the average distance traveled for treatment of breast cancer in the administrative regions and federal states of Brazil. The disparity in the distribution of specialized services stems from the unequal access to breast cancer diagnosis and treatment in Brazil, mainly in highly complex services (chemotherapy and radiotherapy). 55/99 of the Health Care Secretariat of the Brazilian Ministry of Health, ensures the flow of referrals to other regions when the disease is not treatable in the municipality of residence. The flows of the interstate reference of users of the Unified Health System (SUS) are regulated according to the regionalization proposal of each region [11]

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