Demanda y ocupación de camas en el Sistema Único de Salud de los principales tipos de cáncer en Brasil, de 2018 a 2021: estudio transversal

Lima, Mariana Araujo Neves; Villela, Daniel Antunes Maciel

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 33 • 2024 • https://doi.org/10.1590/S2237-96222024v33e20231172.en copiar

Demanda y ocupación de camas en el Sistema Único de Salud de los principales tipos de cáncer en Brasil, de 2018 a 2021: estudio transversal

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo

Evaluar la demanda y ocupación de camas en el Sistema Único de Salud (SUS) de los principales tipos de cáncer en Brasil, de 2018 a 2021.

Métodos

Estudio descriptivo transversal, utilizando datos del Sistema de Información Hospitalaria. Se realizaron cálculos basados en el modelo de teoría de colas de: tasa promedio de ingreso por hospitalización, tasa promedio de hospitalización, probabilidad de sobrecarga y número promedio de personas en lista de espera.

Resultados

Las regiones Sur y Sureste presentaron las tasas promedio de hospitalización más altas, mientras que la región Norte tuvo las tasas más bajas. La región Sureste presentó alta probabilidad de sobrecarga de camas quirúrgicas, sobre todo San Pablo (99,0%), Minas Gerais (97,0%) y Río de Janeiro (97,0%). San Pablo presentó sobrecarga superior al 95,0% en todos los tipos de camas analizadas.

Conclusión

Hubo alta probabilidad de ocupación de camas de oncología en el SUS, mayormente en quirúrgicas y clínicas, además de disparidades regionales en la sobrecarga de camas.

Palabras clave
Acceso a Servicios de Salud; Equidad en el Acceso a los Servicios de Salud; Neoplasias; Investigación operativa, Teoría de colas

Variables	Total N = 898,724	Cervical cancer N = 90,039	Colorectal cancer N = 314,537	Breast cancer N = 271,861	Prostate cancer N = 125,519	Lung cancer N = 96,768
Variables	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)
Sex
Female	55,054 (62.0)	90,021 (100.0)	153,633 (49.0)	268,988 (99.0)	NA	44,412 (46.0)
Male	341,670 (38.0)	NA	160,904 (51.0)	2,873 (1.0)	125,519 (100.0)	52,356 (54.0)
Age group (in years)
Up to18	4,532 (0.5)	105 (0.1)	2,830 (0.9)	796 (0.3)	170 (0.1)	631 (0.7)
19 to 39	82,091 (9.1)	26.235 (29,0)	21.185 (6,7,0)	31.365 (12,0)	177 (0,1)	3,129 (3.2)
40 to 59	342,546 (38.0)	43,001 (48.0)	116,281 (37.0)	137,641 (51.0)	18,525 (15.0)	27,098 (28.0)
60 to 69	251,755 (28.0)	12,536 (14.0)	94,500 (30.0)	60,843 (22.0)	48,416 (39.0)	35,460 (37.0)
70 to 79	161,479 (18.0)	6,251 (6.9)	60,379 (19.0)	30,463 (11.0)	41,165 (33.0)	23,221 (24.0)
80 to 89	51,012 (5.7)	1,738 (1.9)	17,889 (5.7)	9,631 (3.5)	15,058 (12.0)	6,696 (6.9)
90 and older	5,309 (0.6)	173 (0.2)	1,473 (0.5)	1,122 (0.4)	2,008 (1.6)	533 (0.6)
Race/skin/color
Asian	12,068 (1.5)	1,498 (1.9)	4,065 (1.4)	3,442 (1.4)	1,674 (1.6)	1,389 (1.7)
White	414,577 (52.0)	33,133 (43.0)	170,413 (61.0)	118,966 (49.0)	46,104 (43.0)	45,961 (56.0)
Indigenous	343 (< 0.1)	135 (0.2)	85 (< 0.1)	61 (< 0.1)	28 (< 0.1)	34 (< 0.1)
Mixed-race	314,118 (40.0)	38,413 (49.0)	93,565 (33.0)	103,272 (42.0)	49,053 (46.0)	29,815 (36.0)
Black	50,203 (6.3)	4,775 (6.1)	12,705 (4.5)	17,385 (7.2)	10,705 (10.0)	4,633 (5.7)
Region
Midwest	51,712 (5.8)	6,393 (7.1)	17,670 (5.6)	14,945 (5.5)	7,050 (5.6)	5,654 (5.8)
Northeast	177,630 (20.0)	23,409 (26.0)	44,137 (14.0)	60,970 (22.0)	30,947 (25.0)	18,167 (19.0)
North	28,846 (3.2)	7,048 (7.8)	6,265 (2.0)	8,773 (3.2)	3,597 (2.9)	3,163 (3.3)
Southeast	425,812 (47.0)	35,850 (40.0)	144,538 (46.0)	136,769 (50.0)	64,889 (52.0)	43,766 (45.0)
South	214,724 (24.0)	17,339 (19.0)	101,927 (32.0)	50,404 (19.0)	19,036 (15.0)	26,018 (27.0)
Year of treatment
2018	222,479 (25.0)	21,876 (24.0)	76,289 (24.0)	67,994 (25.0)	32,394 (26.0)	23,926 (25.0)
2019	239,360 (27.0)	23,948 (27.0)	81,506 (26.0)	73,093 (27.0)	34,714 (28.0)	26,099 (27.0)
2020	221,196 (25.0)	22,438 (25.0)	78,813 (25.0)	65,884 (24.0)	29,582 (24.0)	24,479 (25.0)
2021	215,689 (24.0)	21,777 (24.0)	77,929 (25.0)	64,890 (24.0)	28,829 (23.0)	22,264 (23.0)
Types of bed
Surgical	426,081 (47.0)	39,088 (43,0)	118,919 (38.0)	175,940 (65.0)	71,630 (57.0)	20,504 (21,0)
Medical	449,465 (50.0)	47.,310 (53.0)	189,781 (60.0)	89,771 (33.0)	50,167 (40.0)	72,436 (75.0)
Others	23,178 (2.6)	3,641 (4.0)	5,837 (1.9)	6,150 (2.3)	3,722 (3.0)	3,828 (4.0)

FU	Medical bed				Surgical bed				ICU bed
FU	Average admission rate (λ)	Average hospitalization rate ( μ )	Probability of overload (ρ) %	Average number of users in the queue (Lq)	Average admission rate (λ)	Average hospitalization rate ( μ )	Probability of overload (ρ) %	Average number of users in the queue ( Lq)	Average admission rate (λ)	Average hospitalization rate ( μ )	Probabil ity of overload (ρ) %	Average number of users in the queue (Lq)
São Paulo	473.1	478.2	99.0	437.1	517.8	525.0	99.0	383.5	104.3	110.0	95.0	93.9
Minas Gerais	269.1	274.2	98.0	234.1	261.2	269.9	97.0	154.9	54.2	60.6	89.0	40.2
Rio Grande do Sul	195.0	199.6	98.0	191.0	158.6	165.9	96.0	131.3	22.8	28.3	84.0	20.3
Paraná	286.8	294.6	97.0	155.3	163.9	173.1	95.0	92.0	34.9	43.4	80.0	17.7
Rio de Janeiro	153.8	158.1	97.0	171.5	164.1	169.9	97.0	149.4	33.2	37.7	88.0	38.0
Santa Catarina	119.0	124.4	95.0	91.9	91.7	100.3	93.0	58.1	14.5	20.9	74.0	8.8
Pernambuco	116.4	121.8	95.0	98.6	92.4	100.0	92.0	52.5	15.9	21.6	73.0	10.5
Bahia	79.0	82.9	95.0	96.6	115.9	124.0	93.0	65.7	17.2	22.6	76.0	13.0
Espírito Santo	75.3	81.2	92.0	53.3	56.0	64.8	87.0	28.7	12.3	19.3	66.0	6.1
Maranhão	36.6	40.9	90.0	40.0	39.2	46.6	85.0	23.2	12.2	17.5	71.0	8.5
Ceará	32.3	36.2	90.0	40.3	72.4	79.8	91.0	43.8	10.5	16.4	69.0	8.3
Distrito Federal	31.7	35.5	89.0	37.2	28.4	34.6	83.0	19.6	6.5	10.5	64.0	5.3
Pará	21.1	24.3	87.0	29.5	23.6	27.6	85.0	23.1	8.5	12.1	71.0	9.2
Rio Grande do Norte	43.9	50.1	86.0	26.0	39.0	48.4	82.0	17.9	9.5	17.3	56.0	3.7
Alagoas	36.6	42.1	86.0	26.1	21.9	30.3	74.0	10.0	6.9	13.2	52.0	2.9
Goiás	35.5	41.6	85.0	24.4	72.4	79.8	91.0	43.8	9.1	16.8	61.0	4.3
Paraíba	24.1	29.2	82.0	19.3	32.1	39.5	81.0	16.6	8.8	15.0	60.0	4.9
Mato Grosso do Sul	30.6	37.2	81.0	17.6	22.8	30.2	78.0	12.9	6.8	13.7	51.0	2.6
Piauí	17.9	22.1	81.0	16.8	27.1	35.0	78.0	13.0	6.9	12.9	54.0	3.6
Sergipe	9.3	11.5	81.0	17.0	12.8	19.9	69.0	7.0	5.8	9.6	63.0	5.5
Mato Grosso	25.2	31.1	80.0	15.5	23.5	30.9	78.0	12.7	8.0	14.7	58.0	3.7
Amazonas	11.3	14.9	78.0	12.7	17.8	23.7	77.0	11.7	6.3	11.1	59.0	4.1
Rondônia	18.3	24.3	75.0	11.5	14.4	22.0	68.0	6.6	7.2	14.6	51.0	2.7
Tocantins	14.8	19.6	75.0	11.6	10.2	15.7	69.0	7.4	5.5	10.4	53.0	3.2
Amapá	6.5	9.2	72.0	9.1	6.4	12.0	60.0	4.0	5.1	8.5	60.0	5.2
Acre	6.9	10.7	65.0	6.0	6.2	11.3	58.0	4.6	5.4	9.6	57.0	4.0
Roraima	7.5	12.0	64.0	5.4	6.4	16.4	43.0	1.6	5.1	10.3	50.0	2.7

Variables	Medical clinic beds	Surgical beds	ICU beds
Region
North	8.8	6.4	12.0
Southeast	6.6	5.2	10.5
Northeast	7.3	4.4	9.7
Midwest	6.3	4.8	10.7
South	5.3	5.0	10.0
Diagnosis
Lung cancer	8.3	7.2	10.1
Cervical cancer	8.2	4.5	12.0
Colorectal cancer	4.8	8.3	11.0
Prostate cancer	7.4	4.5	8.3
Breast cancer	6.9	2.8	8.9
Type of bed
Medical	6.4	-	12.2
Surgical	-	5.0	9.7
Year
2018	6.7	5.2	10.9
2019	6.7	5.1	10.6
2020	6.2	4.9	10.1
2021	6.0	4.7	9.7

Procedure	Average admission rate ( λ )	Average hospitalization rate (μ)	Probability of overload ( ρ ) %	Average number of users in the queue (Lq)
Sequencial procedures	597.5	599.1	100	362.3
Partial colectomy	70.9	71.7	99	93.7
Abdominal recto-sigmoidectomy	65.1	65.8	99	88.6
Treatment with multiple surgeries	63.4	64.2	99	76.9
Radical prostatovesiculectomy	93.5	95.0	98	61.6

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 (61) 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Mariana Araujo Neves Lima | mariananeves.rj@gmail.com