How were we before? An analysis of the potential supply and inequality in the geographic access to critical resources for the COVID-19 treatment

Costa, Deivson Rayner Teixeira da; Barreto, Jorge Otávio Maia; Sampaio, Ricardo Barros

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FREE THEMES • Ciênc. saúde coletiva 27 (04) • Apr 2022 • https://doi.org/10.1590/1413-81232022274.16392021 copy

How were we before? An analysis of the potential supply and inequality in the geographic access to critical resources for the COVID-19 treatment

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The objective was to analyze the situation of the Metropolitan Area of Brasília (AMB) before the onset of the COVID-19 pandemic, focusing on the availability and geographical accessibility of critical resources for the treatment of acute respiratory crises caused by the SARS-CoV-2 virus. Geographic mapping of the population within the territory and geolocation of health facilities and resources, construction of a relationship network between the potential demand simulated to the public health system and the supply of resources available in December 2019. The relationship analysis is based on the theory of complex networks crossing socioeconomic data available in the CENSUS and information from the National Registry of Health Establishments (CNES) and analyzing the micro relationship of census tracts with the stock and availability of health resources concerning Adult ICU Bed Type II/III and Respirators/Ventilators. The Federal District (DF) health facilities concentrate more than 75% of the relationships of potential access to critical resources for the treatment of COVID-19. Although the regions surrounding the DF, belonging to Goiás state, have the greatest relative vulnerability in the studied territory, they are also the most lacking in spatial accessibility and availability of resources, evidencing a care imbalance within the AMB region.

Key words:
COVID-19; Health service access; Public Health; Data science; Complex networks

AMB	(A) % Households with per capita income <0.5 minimum wage				(B) % Households without public water supply				(C) % Households without a sewerage or rainwater network system				(D) % Households without garbage collection				Relative % of the Tract’s Social Vulnerability (A + B + C + D) / 4
	Percentiles
	25	50	75	95	25	50	75	95	25	50	75	95	25	50	75	95	25	50	75	95
Brasília	3	13	25	41	0	0	1	88	0	0	2	95	0	0	0	20	1	4	8	46
Luziânia	25	32	40	51	4	45	92	100	64	96	98	100	0	1	5	99	31	38	58	82
Águas Lindas de Goiás	28	34	40	51	1	6	22	92	87	97	99	100	0	2	10	73	31	35	41	72
Valparaiso de Goiás	12	22	30	44	1	16	48	81	1	12	87	99	0	0	0	36	9	20	32	53
Formosa	18	32	46	58	1	3	21	100	35	69	92	98	0	0	13	100	15	27	41	84
Novo Gama	25	33	39	51	0	3	16	93	8	85	96	99	0	0	3	78	12	32	38	72
Planaltina	27	35	44	56	0	2	30	100	74	92	98	99	0	2	25	98	26	34	50	81
Sto. Ant. de Descoberto	28	37	42	51	1	8	95	99	11	68	95	99	0	3	32	99	15	34	59	81
Cidade Ocidental	17	28	36	49	0	3	24	100	1	61	93	99	0	1	10	92	6	26	39	74
Cristalina	22	31	39	54	1	12	100	100	12	81	97	100	0	5	96	100	19	41	72	83
Padre Bernardo	36	42	47	57	2	68	97	100	70	95	99	100	2	45	91	100	36	61	78	85
Alexânia	31	37	44	50	8	19	97	100	86	98	99	99	0	2	43	96	33	38	62	82
Cocalzinho de Goiás	30	36	41	56	1	82	97	100	85	94	98	100	1	3	83	99	32	53	76	83
Total	5	18	30	46	0	0	3	98	0	0	49	99	0	0	0	68	2	6	27	65

AMB	Territory Vulnerability Mean Standard Deviations
AMB	-1 a -0.51		-0.5 a 0		0.01 a 1		1.01 a 2		>2		Total Tracts
Brasília	2,590	60%	1,018	24%	390	9%	164	4%	131	3%	4,293
Luziânia	11	5%	21	9%	80	33%	68	28%	62	25%	242
Águas Lindas de Goiás	1	1%	18	10%	90	50%	54	30%	16	9%	179
Valparaiso de Goiás	31	18%	41	23%	77	44%	20	12%	6	3%	175
Formosa	7	5%	30	22%	60	44%	9	7%	30	22%	136
Novo Gama	15	12%	23	19%	49	40%	26	22%	9	7%	122
Planaltina	1	1%	13	12%	49	45%	23	21%	22	21%	108
Sto. Ant. de Descoberto	1	1%	20	25%	23	29%	15	19%	21	26%	80
Cidade Ocidental	18	23%	10	13%	28	37%	11	14%	10	13%	77
Cristalina	4	5%	13	17%	19	25%	10	13%	29	40%	75
Padre Bernardo	6	12%	1	2%	9	17%	9	17%	27	52%	52
Alexânia	0	0	3	7%	17	38%	10	23%	14	32%	44
Cocalzinho de Goiás	1	3%	0	0	12	36%	8	24%	12	36%	33
Total	2,686	47%	1,211	22%	903	16%	427	8%	389	7%	5,616

Establishment	Coverage of Respirators on the Potential Demand of 1% of the Population
Establishment	Distance P50/P75 (KM) (A)	Potential Demand (Centrality) (B)	Demand/ Respirators (C)	Normalized Centrality (D=E+F)	Normalized Centrality DF (E)	Normalized Centrality Surroundings (F)
Hospital Reg. Sta. Maria	5.4/7.9	4,402.87	22.24	0.124	0.037	0.087
Hospital São Francisco (Ceilândia)	5.3/19.6	4,219.40	210.97	0.119	0.091	0.028
Hospital Reg. Samambaia	6.0/7.3	4,043.22	122.52	0.114	0.112	0.002
Hospital Reg. Taguatinga	3.2/5.4	2,196.40	27.80	0.062	0.060	0.002
Hospital Reg. Planaltina	4.7/15.6	2,178.67	217.87	0.062	0.043	0.018
Hospital Reg. Sobradinho	5.2/7.7	1,831.69	32.71	0.051	0.050	0.001
Hospital Reg. Ceilândia	9.0/22.2	1,618.69	43.75	0.045	0.031	0.014
Hospital Reg. Gama	3.1/20.6	1,524.37	56.46	0.043	0.035	0.008
Hospital da Região Leste	7.2/14.4	1,240.52	62.03	0.035	0.034	> 0.001
Hospital DOMED (Ceilândia)	11.1/21.7	1,215.49	63.97	0.034	0.025	0.009
Hospital São Mateus (Cruzeiro)	5.3/6.5	1,193.31	51.88	0.033	0.033	> 0.001
Hospital Reg. Asa Norte	3.7/5.2	1,066.99	62.76	0.030	0.030	> 0.0001

Establishment	Coverage of Type II Adult ICU Beds on the Potential Demand of 1% of the Population
Establishment	Distance P50/P75 (KM) (A)	Potential Demand (Centrality) (B)	Demand/ Beds (C)	Normalized Centrality (D=E+F)	Normalized Centrality DF (E)	Normalized Centrality Surroundings (F)
Hospital Reg. Sta. Maria	10.9/25.2	6,067.66	209.23	0.171	0.038	0.133
Hospital Reg. Samambaia	6.7/19.0	5,664.53	283.23	0.160	0.139	0.021
Hospital DOMED (Ceilândia)	5.1/21.2	4,243.45	326.42	0.120	0.096	0.024
Hospital da Região Leste	21.3/40.7	3,547.63	394.18	0.100	0.074	0.026
Hospital Reg. de Sobradinho	19.8/34.7	3,211.78	535.30	0.091	0.073	0.018
Hospital Reg. Taguatinga	7.9/24.7	2,462.27	410.38	0.069	0.060	0.009
Hospital Reg. Ceilândia	5.2/21.3	2,179.48	363.25	0.061	0.050	0.011
Hospital São Mateus (Cruzeiro)	6.5/8.5	1,881.08	235.14	0.053	0.052	0.001
Hospital da Região do Gama	22.0/29.9	1,772.46	221.56	0.050	0.036	0.014
Hospital Reg. Asa Norte	5.5/6.3	1,673.96	167.40	0.047	0.039	0.008
Hospital Materno Infantil de Brasil.	10.1/17.6	1,301.86	325.47	0.036	0.035	0.001
	Coverage of Type III Adult ICU Beds on the Potential Demand of 1% of the Population
Inst. De Cardiologia do DF	22.0/34.6	16,465.77	823.29	0.466	0.360	0.106
Hospital de Base do DF	26.9/36.0	11,771.08	588.55	0.333	0.227	0.106
Hospital SARAH Brasília	26.9/36.1	7,056.59	588.05	0.199	0.136	0.063

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E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

DRT Costa worked on the conception and design of the research, writing of the article, analysis and interpretation of data. JOM Barreto worked on the conception and design of the research, critical review and theoretical contributions and approval of the final version. RB Sampaio worked on the critical review and theoretical contributions and approval of the final version.