SUS has dropped more than 900 million procedures during the pandemic

The new coronavirus pandemic impacted the procedures performed by the SUS (Unified Health System). There was a reduction of more than 900 million assistances and actions in the period.

The data are from a survey by Fiocruz (Oswaldo Cruz Foundation) to which the sheet had access with exclusivity. For comparison, pre-pandemic data from January 2018 to June 2019 and during the pandemic from January 2020 to June 2021 were used.

There were 4.058 billion procedures in the pre-pandemic period against 3.114 billion during the pandemic. The total reduction is 23.25%.

Eight groups of procedures are included in the survey, ranging from actions and health promotion, exams, surgical and clinical procedures, organ transplants to the implantation of orthosis and prosthesis.

In the data, it is possible to observe that all groups, with the exception of the implantation of orthotics, prostheses and special materials, had a sudden fall shortly after the beginning of the pandemic and had not yet returned to the previous level.

The Ministry of Health was contacted, but did not respond until the conclusion of this report.

The surgery group was the most harmed. The drop was 53.47% compared to the pre-pandemic period, with 36.7 million fewer procedures.

Even the diagnostic procedures group, even with the increase in the number of tests to detect Covid-19, which were not counted before the pandemic, had a drop of 12.8%.

The comparison also showed a 9.9% reduction in the total number of elective and emergency admissions, which represents about 1.7 million fewer records than before the pandemic.

When these hospitalization data are separated by disease class, only the group of “some infectious and parasitic diseases”, which includes hospitalizations by Covid-19, showed a significant increase of 86%.

Diego Xavier, a researcher at Fiocruz’s Institute of Communication and Scientific and Technological Information in Health and responsible for the survey, said that the drop in procedures has a great impact on the SUS and reflects the problem of damming that the country will have to face.

For him, the consequence is that queues will increase, which will require investment to identify problems that could not be diagnosed during the pandemic. This includes, for example, hiring more teams and carrying out specific joint efforts for certain procedures.

“There are many diseases that were not discovered because of the pandemic and may not even be treated as a result,” he said.

The survey also shows the distribution of medicines from the SUS. This type of procedure is not included in the total amount of procedures.

239.6 million more medicines were delivered to the population, a growth of 16.45%. In this group there are capsules, pills and ampoules.

Data were collected from SIA (Outpatient Information System), SIH (Hospital Information System), SIM (Mortality Information System), SIVEP-Influenza and the Ministry of Health’s Coronavirus Panel.

According to Xavier, the observation of data from different information systems helps to understand the lack of assistance in health that the country faced during the Covid-19 epidemic.

For him, it is necessary to monitor, in the long term, the indirect impacts that will result from Covid-19, especially in cases that could not be attended to at the right time.

A possible reflection of this impoundment would be, for example, in relation to elective surgeries for glaucoma and cataract that had a fall. If performed at opportune times, they would avoid aggravation of the problem, otherwise blindness may occur.

The Conass (National Council of Health Secretaries) said, in a statement, that progressing in public health policies and normalizing care and surgical procedures will not be possible with fewer resources for the area and without collective efforts.

According to the council, the resumption of surgeries dammed up because of the Covid-19 pandemic has been a permanent issue at Conass assemblies and taken to the meetings of the SUS’s Tripartite Inter-manager Commission.

“Conass has highlighted the concern of state managers for meetings with the Ministry of Health and Conasems [gestores municipais], especially in relation to the financing of procedures and beds and the availability of resources for elective surgeries. The incorporation of ICU beds in the care network is also a constant issue,” he said in a statement.

Fatima Marinho, an epidemiologist and senior specialist at Vital Strategies, said there could be an increase in deaths from other diseases in the coming years because of late diagnosis.

“Many patients who could benefit from early treatment, resulting in increased survival and cure, will have a late diagnosis with reduced survival and increased mortality,” he said.

A sheet showed that the pandemic and the rise in the dollar held back heart surgeries in the SUS.

The SBCCV (Brazilian Society of Cardiovascular Surgery) estimated that around 50 thousand people are waiting in line for operations of this type. This number of calls drops every year.