Impacto da COVID-19 no serviço de atendimento móvel de urgência

Abstract

The pandemic caused by COVID-19 has resulted in a high number of deaths and led to changes in the lifestyles of the global population. Recommendations to contain the increase in the number of cases, such as social isolation, the suspension of elective medical appointments, the substitution by teleconsultations, and the fear caused by COVID-19 have brought changes in the profile of care provided by urgent and emergency services. The Serviço de Atendimento Móvel de Urgência (SAMU) is an essential component of Brazil's emergency network and aids people suffering from health problems who need rapid intervention or prompt and assisted transportation. SAMU Macro Norte (Northern Macroregion) provides services to 86 municipalities in the North of Minas Gerais and has its headquarters in the city of Montes Claros, Minas Gerais. This study aimed to evaluate the impact of the COVID-19 pandemic on the services provided by SAMU Macro Norte, comparing those that occurred during the pandemic period, from March 2020 to February 2021, with the pre-pandemic period, from March 2018 to February 2020. This is an analytical cross-sectional study with a quantitative approach, using secondary data from pre-hospital care records of occurrences registered by SAMU Macro Norte - Minas Gerais, Brazil. Data collection took place from June to August 2021 at the statistics sector of SAMU Macro Norte. The data was released in the Statistical Package for the Social Sciences® - SPSS, version 24.0 (SPSS for Windows, Chicago, USA). A total of 139,354 occurrences registered between March 2018 and February 2021 were included in this study. A descriptive analysis of the sample was conducted with absolute (n) and relative frequency (%), followed by bivariate analyzes using Pearson's chi-square (χ²) test, with a significance level of 5%. There was a 3.31% reduction in the total number of consultations during the pandemic period. Regarding demographic characteristics, it was observed that the number of occurrences involving female victims was lower during the pandemic (p < 0.001), with an increase in those over 60 years old (p<0.001) and a decrease in those under 19 years of age (p<0.001) during the pandemic period. In the analysis of occurrence outcomes, the main change was related to the 35% increase in the number of deaths at the scene during the pandemic (p<0.001), as well as an increase in the number of refusals of care or victim evasion by 11.8%. In attendances for external causes/trauma, there was a reduction of 8.38% (p< 0.001) and 13.36% (p<0.002) in gynecological-obstetric cases, in addition to an increase of 17.38% in psychiatric cases (p<0.001) during the pandemic. The pandemic caused a reduction in the number of attendances overall, especially in cases of external causes/trauma. However, it was associated with an increase in the number of deaths at home and psychiatric care. Therefore, it is concluded that the services provided by SAMU during the pandemic period underwent changes in their pattern, possibly due to the impact of social isolation and the fear caused by