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COVID-19 大流行对巴西国家卫生系统产前、糖尿病和医疗预约的影响。

Impact of the COVID-19 pandemic on prenatal, diabetes and medical appointments in the Brazilian National Health System.

机构信息

Biological and Health Sciences Center, Graduate Program in Dentistry, Universidade do Vale do Taquari - Lajeado (RS), Brazil.

Department of Social and Preventive Dentistry, Graduate Program in Dentistry, Universidade Federal de Pelotas - Pelotas (RS), Brazil.

出版信息

Rev Bras Epidemiol. 2021 May 28;24:e210013. doi: 10.1590/1980-549720210013. eCollection 2021.

Abstract

OBJECTIVES

The purpose of this study was to describe the impact of the COVID-19 pandemic on Primary Health Care in Brazil.

METHODOLOGY

This retrospective ecological study was carried out using Brazilian municipality data obtained from the information systems of the National Public Health System. The outcomes were medical appointments, prenatal procedures and diabetes care. The exposure variable was the occurrence of the COVID-19 pandemic, based on the first case reported in Brazil. Multilevel mixed-effects negative binomial regression was used to analyze the association between the number of procedures per 10,000 inhabitants and COVID-19.

RESULTS

Data from 5,564 Brazilian municipalities were included in the present study. Regarding medical appointments, the largest reduction occasioned by the pandemic occurred in May (IRR = 0.27, 95%CI 0.24 - 0.30). Prenatal procedures were reduced by 65% (IRR = 0.35, 95%CI 0.32 - 0.38), also in May. In addition, diabetes care saw the biggest reductions in April 2020 (IRR = 0.24, 95%CI 0.11 - 0.53) and May 2020 (IRR = 0.19, 95%CI 0.09 - 0.43). From February to December 2020, the pandemic had a significant effect on the total number of procedures evaluated.

CONCLUSION

The findings showed a reduction in prenatal procedures, diabetes and medical consultations performed in Brazil's Primary Health Care, following the onset of the COVID-19 pandemic.

摘要

目的

本研究旨在描述 COVID-19 大流行对巴西初级卫生保健的影响。

方法

本回顾性生态研究使用从国家公共卫生系统信息系统获得的巴西市数据进行,结果为医疗预约、产前程序和糖尿病护理。暴露变量是 COVID-19 大流行的发生,基于巴西首例报告病例。使用多水平混合效应负二项回归分析每 10000 居民的程序数量与 COVID-19 之间的关联。

结果

本研究共纳入了 5564 个巴西市的数据。关于医疗预约,大流行导致的最大降幅发生在 5 月(IRR=0.27,95%CI 0.24-0.30)。产前程序减少了 65%(IRR=0.35,95%CI 0.32-0.38),也是在 5 月。此外,2020 年 4 月和 5 月糖尿病护理的降幅最大(IRR=0.24,95%CI 0.11-0.53 和 IRR=0.19,95%CI 0.09-0.43)。2020 年 2 月至 12 月,大流行对评估的总程序数量产生了重大影响。

结论

研究结果表明,巴西初级卫生保健中,产前程序、糖尿病和医疗咨询的数量减少,这是 COVID-19 大流行开始后的结果。

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