Restructuring of emergency services to COVID-19 in Brazil: a space-time analysis from February to August 2020

Abstract

Objective  To explore the reorganization of the health system in response to the COVID-19 pandemic.

Methods  We conducted an ecological, descriptive-exploratory study with analysis of spatio-temporal clusters by epidemiological week in Brazilian municipalities. Secondary data sources were used, from the National Health Establishment Registry (April 2020) and on COVID-19 cases, February to August 2020. Intensive Care Units (ICU) availability was overlaid on incidence and mortality hot spots in order to assess expanded access in critical regions.

Results  Of the 5,570 municipalities analyzed, 54% were identified as incidence hot spots and 31% as mortality hot spots. Of the municipalities in incidence hot spots and with scarce access, 28% were covered by ICU expansion, while with regard to mortality 14% were covered.

Conclusion  The opening of new beds was not able to provide broad coverage for critical regions and could be optimized with the use of spatial analysis techniques.

Keywords:
Ecological Studies; Geographic Information Systems; Barriers to Access of Health Services; Effective Access to Health Services; Coronavirus Infections; Intensive Care Units