Inpatient flow for Covid-19 in the Brazilian health regions

Silva, Everton Nunes da; Soares, Fernando Ramalho Gameleira; Frio, Gustavo Saraiva; Oliveira, Aimê; Cavalcante, Fabrício Vieira; Martins, Natália Regina Alves Vaz; Oliveira, Klébya Hellen Dantas de; Santos, Leonor Maria Pacheco

doi:10.1590/0103-1104202113113I

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Brasil

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ORIGINAL ARTICLE • Saúde debate 45 (131) • Oct-Dec 2021 • https://doi.org/10.1590/0103-1104202113113I copy

Inpatient flow for Covid-19 in the Brazilian health regions

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

KEYWORDS
Covid-19; Regional health planning; Hospitalization; Movement and displacement of patients

Region	Period of hospitalization demand	Population Size of the hospitalized patient home Health Region						Total
Region	Period of hospitalization demand	up to 100 thousand	100 to 200 thousand	200 a 500 thousand	500 thousand to 1 million	1 to 2 millions	Above 2 millions	Total
North	Total	38.5%	24.8%	15.9%	9.6%	-	1.7%	9.8%
	Higher demand	45.1%	27.0%	15.9%	11.4%	-	1.8%	10.3%
	Lower demand	36.3%	23.9%	15.9%	8.9%	-	1.7%	9.6%
Northeast	Total	62.9%	55.7%	40.7%	23.6%	5.0%	0.8%	17.6%
	Higher demand	61.9%	55.9%	42.5%	24.7%	4.8%	0.9%	19.1%
	Lower demand	63.5%	55.6%	40.0%	23.3%	5.0%	0.8%	17.0%
Southeast	Total	34.8%	20.4%	11.2%	9.9%	23.3%	7.5%	10.6%
	Higher demand	37.2%	19.3%	12.0%	9.4%	22.3%	7.0%	10.5%
	Lower demand	33.8%	20.8%	11.0%	10.0%	23.5%	7.6%	10.7%
South	Total	-	23.9%	14.1%	8.9%	4.2%	1.3%	8.8%
	Higher demand	-	24.7%	15.1%	9.1%	4.1%	1.2%	10.3%
	Lower demand	-	23.6%	13.7%	8.8%	4.2%	1.3%	8.4%
Center-west	Total	36.8%	28.8%	19.1%	28.9%	7.5%	1.0%	12.4%
	Higher demand	39.5%	32.5%	17.7%	26.2%	8.5%	1.2%	14.2%
	Lower demand	35.6%	27.4%	19.6%	29.6%	7.3%	1.0%	11.9%
Brazil	Total	36.9%	30.9%	20.3%	14.0%	12.8%	5.2%	11.9%
	Higher demand	40.0%	32.1%	22.2%	14.7%	11.3%	4.7%	12.9%
	Lower demand	35.5%	30.4%	19.7%	13.8%	13.2%	5.3%	11.7%

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[1] Conflict of interests: non-existent