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. 2022 Feb:155:106914.
doi: 10.1016/j.ypmed.2021.106914. Epub 2021 Dec 22.

Repercussions of the COVID-19 pandemic on preventive health services in Brazil

Mayra Monteiro de Oliveira  1 , Trevon L Fuller  2 , Claudia R Gabaglia  3 , Mary Catherine Cambou  4 , Patricia Brasil  5 , Zilton Farias Meira de Vasconcelos  5 , Karin Nielsen-Saines  6
Affiliations

Repercussions of the COVID-19 pandemic on preventive health services in Brazil

Mayra Monteiro de Oliveira et al. Prev Med. 2022 Feb.

Abstract

Introduction: The increasing burden of non-communicable diseases and limited public financing are major challenges facing health care systems in Latin America. Although COVID-19 severely impacted the Brazilian health care system, it is crucial to further characterize the degree of disruption caused to public health efforts, in order to address and manage long term effects of this pandemic. We therefore quantified the demand for preventive and treatment services from the Brazilian Unified Health System (Sistema Único de Saúde/SUS) in 2020 to evaluate potential repercussions of COVID-19 in this setting.

Methods: Using the SUS database, we compared preventative and treatment services rendered in 2020 to the same services rendered from 2017 to 19. We also evaluated the frequency of respiratory infection (RI) diagnoses during the pandemic, relative to the preceding years.

Results: Compared to 2017-19, in 2020 non-urgent medical appointments decreased 1.4-fold (p = 0.0017), dental consultations 2.8-fold (p = 0.05), and immunization coverage 1.5 fold (p = 0.0005). The number of RI visits to SUS ambulatory care units in 2020 was 4.2 times higher than in preceding years (p = 0.0014), with a peak of 280,898 diagnoses in July 2020.

Conclusion: The COVID-19 pandemic appears to have led to a dramatic decline in preventative and treatment services provided by SUS to the Brazilian population. Our findings may aid decision-makers in formulating policies to increase the availability of outpatient services in the aftermath of the pandemic. Counter measures will be critical to avoid a resurgence in vaccine-preventable diseases and complications stemming from non-communicable, chronic health conditions.

Keywords: COVID-19; Immunization; Public health; Public policy; Vaccination.

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Figures

Fig. 1
Fig. 1
A. Mean number of monthly medical consultations at primary health care facilities in Brazil March–December 2017–2020. B. Mean number of monthly dental consultations at primary care facilities in Brazil March–December 2017–2020. C.Title: Mean number of monthly SUS domiciliary visits across Brazil, March–December 2017–2020.
Fig. 2
Fig. 2
Total number of vaccine doses administered by SUS in Brazil from 2017 to 2020.
Fig. 3
Fig. 3
Number of elective non-emergent admissions to SUS hospital facilities per year from March–December 2017 to 2020.
Fig. 4
Fig. 4
Number of total cases of RIs diagnosed at SUS ambulatory facilities across Brazil from March–December 2017 to 2020.
See this image and copyright information in PMC

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