Tendência e sazonalidade de atendimento móvel de urgência da macrorregião do Sul de Minas

Abstract

The time-series study can provide various information that allows assessing how social, environmental, and regional contexts can affect the population's health and predicting futures improvements. This study aimed to characterize the trend and seasonality of mobile emergency pre-hospital care service and deaths in the Health Regions of the Intercity Health Consortium of the South of Minas Gerais (CISSUL). Therefore, this research used the time-series study method, constituting "eligible population" the secondary data of the services provided to the inhabitants of the 153 consortium cities to CISSUL, in the period from 02/01/2015 to 09/30/2019. The data were collected from the CISSUL digital information system through spreadsheets created from the services provided and the variables of interest for the research. All services provided in the referred period were included in the study, adopting the services that presented information inconsistencies among the variables as exclusion criteria. Initially, an analysis of the quality of the information was carried out according to the completeness of the database, selecting the variables with completeness adequate indexes. After that, it was carried out a descriptive analysis of the variables through absolute and relative frequency. In the following, a descriptive analysis of the variables was carried out through absolute and relative frequency. Finally, the time-series analysis was carried out through the linear regression model and the least-squares method, selecting "mobile emergency pre-hospital care services" and "deaths" as dependent variables and the constant, time coefficient, and month’s year as dependent independent variables. The models were analyzed and adjusted for each Health Region, selecting a significant p-value (<0.05). The variables exit to the hospital, entry to the hospital, history, observation, and conduct, were excluded from the study because they did not present adequate completeness indexes (score <9.9%). Most of the care services were clinical (63.8%), male (54.8%), and age group over 60 years (31.7%). There was a tendency towards increasing the number of services among all CISSUL's Health regions and a slight increase in deaths in the Passos, Pouso Alegre, and Varginha regions. Just the Pouso Alegre region presented a seasonality of deaths, increasing in May, June, July, August, and October. The present study shows the importance of the correlation between the regional disparities observed with the care service offered at the primary level of attention to health to subsidize action plans for possible corrections of the services and the monitoring of the health conditions of its users, reflecting in a better redirection and public spending optimization. In addition, it stood out the necessity of permanent health education and qualification of the teams in the zeal with the production of health information, because the incompleteness of the variables mentioned can harm the continuity of the care at the hospital level, create judicial issues due to lack of proper registry, as well as being an obstacle to the construction of the epidemiological profile of mobile emergency pre-hospital care service in the South of Minas macro-region.