Cobertura da atenção primária à saúde e leitos de internação na ocorrência de óbitos por COVID-19 nas capitais brasileiras

Abstract

The new coronavirus triggers Severe Acute Respiratory Syndrome 2 (SRAG2), generating a high increase in deaths. The first contact of cases with the health system in Brazil is primary care, mainly in the Family Health Strategy (FHS) before accessing hospitals. Objective This study aimed to estimate the effect of the interaction between the coverage of the qualified FHS and the coverage of hospital beds in the incidence of deaths in the capitals of the Brazilian states until the 26th epidemiological week. Methods Ecological study with a design of analytical time series between the 9th and 26th epidemiological weeks. The outcome was the incidence of deaths and the independent variables the coverage of the FHS, note of the National Program for Improvement of Access and Quality of Primary Care (PMAQ), coverage of hospital beds and socioeconomic indicators of Brazilian capitals. The data were materialized by Generalizable Linear Models, adopting α≤0.05%. Results and conclusions It was observed a higher concentration and speed of deaths in the capitals with less coverage of the FHS and less qualified when there were less than 3,2 hospital beds per thousand inhabitants On the other hand, in capitals with more than 3,2 hospital beds per thousand inhabitants, the highest coverage of the FHS and PMAQ scores above 2 major determinants. In addition, in both bed proportion contexts, greater social inequality and city development promoted an increase in deaths. Therefore, a robust care line for urgencies and emergencies with a strong FHS accompanied by hospital services with timely access mitigates the speed and burden of deaths from COVID-19. However, one cannot neglect the socioeconomic aspects in the intervention actions.