A atenção sedundária à saúde na pandemia da Covid-19 em Minas Gerais: uma análise empírica da resposta do SUS no enfrentamento aos casos graves

Abstract

Introduction: In a sudden crisis situation such as COVID-19, the sudden increase in acute health cases resulting from a disease previously uncategorized by health systems further aggravates the problems caused by the limited resources dedicated to providing public services. If in normal times there is already difficulty in meeting the range of demands for public health services, when a pandemic of a new disease emerges, the impact is devastating in inverse proportion to the response capacity of health systems. Research Problem and Objective: In this scenario, where time is running out for the system, the articulation of coordinated actions between the levels of health care becomes even more urgent. At the second level of care (secondary care), it would be up to the system to seek micro-regional resolution in the care of serious cases. Therefore, the present study has the general objective of investigating the response capacity of SUS-MG in dealing with serious cases of COVID-19, specifically in relation to medium complexity hospital services. Theoretical Basis: According to the Health Services Performance Assessment Matrix, the main determinants related to health problems must be verified within the political, social and economic context. Identifying these problems allows us to understand the health conditions of the population through indicators of mortality, morbidity, limitation of physical activity and quality of life in their different regions. In turn, health needs guide the structure of the health services system that determines the performance of health services (PROADESS, 2023). Methodology: This empirical research uses a quantitative approach to analyze the response of the SUS in the State of Minas Gerais regarding the confrontation of severe cases of COVID-19, whose treatment, at a medium complexity hospital level, required the urgent expansion and regional distribution of beds, according to the increase in the corresponding micro-regional morbidity levels, especially in the first two years of the pandemic. For this purpose, the methodological structure is based on the Health System Performance Assessment Dimension Matrix – MDADSS. Analysis of Results: The results showed that the system responded with increased financial investments and an equitable increase in beds, directing more beds to the microregions that had the highest number of deaths. Additionally, the structure demonstrated better resolution in the microregions that recorded the highest increase in beds. Conclusion: Finally, this research showed that the first two years were those with the highest incidence of deaths, therefore the years of greatest concern in public health in order to avoid the transmission of the disease through prevention and care measures, and that the SUS-MG responded assertively with regard to increasing funding and the number of beds during the period of highest peaks of the disease and in most of its microregions in Minas Gerais, despite some exceptions.