Procura por assistência à saúde em pronto atendimento de uma região ampliada de saúde

Abstract

In the health care system, the area of emergency care has undergone enormous changes in recent years, mainly as a result of the demand for care that could otherwise be supplied by other parts of the healthcare system. Other challenges exist in the state of Minas Gerais, including the vast size of the state, which has 853 municipal districts and significant regional differences in terms of demographic density and socioeconomic characteristics. In the Jequitinhonha/Mucuri region, challenging socioeconomic conditions and low demographic density affect access to health care services. The municipality of Diamantina is the healthcare hub for the health region of Diamantina and the wider health region of Jequitinhonha. Despite being a hub, it has some specific problems: primary care with only ten Family Health Care teams (FHC), four Community Health Agent Programs (CHAP) and Basic Health Units (BHU) and only two hospitals. The only health center that provides accident and emergency care is the Santa Isabel Emergency Room (ER), linked to the Santa Casa de Caridade de Diamantina (SCCD) (Diamantina Santa Casa Charity), a referral center for accident and emergency care in the Jequitinhonha wider health care region, which comprises 23 municipalities. Additionally, rural areas in some regions do not possess BHU, FHC or CHAP; or have only weekly or fortnightly health care. In such cases, the Emergency Room is the only health care unit that operates for 24 hours, treating more serious cases in the municipality and the region. The aim of this study is to analyze the reasons why health care treatment is sought in the Santa Isabel Emergency Room in Diamantina/MG, between January and October 2013, in the form of a descriptive Case Study, using secondary data collected from the ALERT ADW software program during the first ten months of the implementation. Sociodemographic; Flowchart (from the users medical complaint), Diagnostic and Classification of Risk data was analyzed. The data was organized in graphs and tables, together with frequency distribution. The results show that there was higher demand in june (11.36%), july (11.33%) and february (10.58%). The ER was used by adults, the elderly and adolescents, who represented 59.87%, 18.01%, and 12.18% of users respectively, and the majority of users were female (52.81%) and from the national public health system (83.99%). The majority of users were released from hospital (53.62%). Many diagnoses were found in the chapters of ICD10: XIX - Injury, poisoning and certain other consequences of external causes (17.19%); X - Respiratory diseases (9.8%); XVIII - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (9.7%). In the ER category patients classified as flowchart colors red, orange or yellow, the complaints of feeling unwell among adults (6.20%), abdominal pain among adults (5.25%), headache (3.77%) and chest pain (3.65%) stood out. In the category patients classified as green and blue that can be treated in the ER the flowcharts feeling unwell among adults (5.01%), throat pain (2.07%), wounds (2%) and discomfort in the extremities (1.73%) were worthy of note. Therefore, the Diamantina ER meets the urgent demand for emergency care, but also the needs of users that could be met elsewhere in the health network, burdening the system and causing overcrowding of the service, a characteristic of Emergency Rooms in a number of regions and municipalities.