Gestão da atenção primária à saúde na pandemia pelo covid-19 em município paulista brasileiro

Abstract

To assess epidemiological aspects of Covid-19 as a management strategy and the evolution of revenues and expenses in the actions planned and carried out to serve the population by the Primary Health Care of the Unified Health System, to fight the pandemic in a municipality São Paulo. Method: This is a single case study. The population consisted of 16 Primary Health Care units, 13 of the Family Health Strategy type and three of the traditional model. The study was oriented towards the work process at two levels of data collection and quantitative analysis (production and cost). For evaluation criteria, instruments recommended by the Ministry of Health, the Municipality's Contingency Plan, document analysis and secondary data from the information system of the Municipal Health Department of the municipality under study were used, in the period from March to December 2020. For the treatment of data, descriptive and inferential statistical analysis was performed. Results: 6,859 positive cases were reported; 29.00% of men with higher risk of positivity and hospitalization, 56.70%. The average age of the total number of cases was 42 (SD-18.36) years and the average hospitalized was 61 (SD-17.00) years. Of the total, 17.15% had risk factors/co-morbidity and of those admitted, 48.44%. Admissions of moderate and severe cases represented 5.61% and severe cases in the Intensive Care Unit, 2.33%. The mortality rate was 1.81%, mortality risk 130.05/100,000 inhabitants and non-hospitalized 92.06%. The cost of health care in the period analyzed to fight the pandemic totaled R$2.45/per capita, of the Covid-19 investments 43.36% in Primary Health Care and 97.44% of the resource was executed; Conclusion: Epidemiological data were used in the assessment for the contingency plan. The existing budget and the specific resources, presented several adjustments in the analyzed period regarding the attendance at different levels of complexity. It is suggested in the fight against pandemics management instruments articulated contingency plan and epidemiological profile to support technical and budgetary actions in a timely manner.