Spatial analysis of specialized care in the Network for People with Disability: the case of Minas Gerais, Brazil.

Fernanda Jorge Maciel,Gabriela Cintra Januário,Roberta Alvarenga Reis,Stela Maris Aguiar Lemos,Amélia Augusta De Lima Friche,Raimundo De Oliveira Neto,Mônica Farina Neves Santos

doi:10.1590/2317-1782/20202018104

Abstract

To map the Care Network for People with Disabilities in Minas Gerais, based on the identification of the points of care in the rehabilitation specialized care component, its modalities and distribution according to the population. Cross-sectional descriptive study. We used geoprocessing techniques to describe the distribution of the specialized care devices of the Network Care, as surveyed in April 2014. The regions of the state described in the State Regionalization Master Plan were adopted as analysis units. We analyzed data from National and state legislations and data available in the management reports of the Minas Gerais State Health Department. The presence of points of care in the territory, the type of service offered and its relationship with the population density were selected as variables. We performed a descriptive spatial analysis of the distribution of the points care considering the selected georeferenced variables and the type of service as well as the modalities of disability. The Network Care is composed of 183 points of care with the higher concentration in the south of the state: 135 (73.8%) Specialized Services in Rehabilitation of Intellectual Disability, 18 (9.8%) Physical Rehabilitation Services, 15 (8.2%) Auditory Rehabilitation Services, 3 (1.6%) Visual Rehabilitation Services and 12 (6.6%) Specialized Rehabilitation Centers with two or more modalities. We observed greater concentration of services in the most populous regions. The Network Care presents great disproportion between rehabilitation modalities, with a greater number of services aimed at intellectual rehabilitation, and unequal distribution reflected in the care gap.

Highlights

The constitution of regionalized and integrated health care networks is an indispensable condition for care qualification and continuity
The Disability Care Network consists of 183 points of care service: 135 (73.8%) Specialized Services in Rehabilitation of Intellectual Disability (SSRID), 18 (9.8%) Physical Rehabilitation Services (PRS), 15 (8.2%) Hearing Rehabilitation Services (HRS), 3 (1.6%) Visual Rehabilitation Services and 12 (6.6%) Specialized Rehabilitation Centers (SRC) with two or more modalities (Table 2)
The current study contributes to the discussion of the spatial configuration of the Disability Care Network and infers about access to specialized rehabilitation services

Summary

Introduction

The constitution of regionalized and integrated health care networks is an indispensable condition for care qualification and continuity. The networks represent an instrument for guaranteeing the right to health, by expanding access and reducing inequalities, and allow overcoming gaps in care, rationalization and optimization of available care resources[1]. The concept of networks covers actions and services of different technological densities, which are integrated through technical, logistical and management support systems, with the sole objective of ensuring comprehensiveness and continuity of care[2]. The decentralization aims to ensure comprehensive care, rational expenses, resource optimization, and equity to guarantee the right to health. Its role in the integration of the units and services that make up the network is essential, considering their different technological densities[3,4]

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