Efeitos da pandemia de COVID-19 nas hospitalizações por condições sensíveis à Atenção Primária à Saúde, em Salvador, Bahia.

Abstract

The COVID-19 pandemic and the imposition of social distancing have influenced the organization of health services, with repercussions on different morbidity and mortality indicators. The role of Primary Health Care (PHC) in pandemics is fundamental, since appropriate interventions can be carried out based on territorial linkage and recognition of the population covered. This study aimed to assess the effect of the COVID-19 pandemic on Hospitalizations for Conditions Sensitive to Primary Health Care (HACSC) in Salvador, Bahia. This is an ecological study, which analyzed hospital admissions (854,525) between 2017 and 2022, breaking down general and sensitive causes. The descriptive analysis was based on the characteristics of HACSC (main groups of causes, age group and gender), the evolution of PHC coverage in Salvador and the identification of the main temporal milestones in the adoption of social distancing measures. Interrupted time series analysis was used to assess the effect of the COVID-19 pandemic and its repercussions related to measures to restrict mobility and reorganize health services. There was a significant reduction in the number of general hospitalizations in the first year of the pandemic (2020) and among the HACSC group, those due to cerebrovascular diseases were in first place in all the years of the study. When analyzing the use of Intensive Care Unit (ICU) beds among HACSC, there was a considerable increase in the severity of these causes, especially cerebrovascular diseases, bacterial pneumonia and heart failure, as well as hypertension. The proportion of HACSC fell immediately after March 2020 and the proportion of ICU bed utilization increased substantially after this period. The number of HACSC requiring ICU beds, which was stable pre-pandemic, increased substantially between March/2020 and December/2021. The results of this study indicate that the COVID19 pandemic has led to changes in the profile of hospitalizations, with an increase in the severity of HACSC. It is possible to assume that the consequences of the pandemic are still to be observed in the medium and long term, given that the repercussions of the pandemic have not yet materialized in increased hospitalizations in the population of Salvador-BA.