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. 2023 May 26;57(suppl 1):9s.
doi: 10.11606/s1518-8787.2023057004807. eCollection 2023.

Specialized Rehabilitation Centers (CER) in the SUS and the impact of the covid-19 pandemic

[Article in English, Portuguese]
Bianca Tomi Rocha Suda  1 , Paulo Henrique Dos Santos Mota  2 , Aylene Bousquat  2
Affiliations

Specialized Rehabilitation Centers (CER) in the SUS and the impact of the covid-19 pandemic

[Article in English, Portuguese]
Bianca Tomi Rocha Suda et al. Rev Saude Publica. .

Abstract
in English, Portuguese

Objective: To analyze the impact of the covid-19 pandemic on the functioning of Specialized Rehabilitation Centers (CER) in the SUS.

Methods: An analysis of the variation in outpatient production of the CER was carried out based on data from the Outpatient Information System of the Unified Health System (SIA-SUS) from March 2019 to December 2021. Such results were compared with CER managers' perceptions about the impacts of the pandemic on the units, measured by a web survey applied between November 2020 and February 2021. Monthly averages of 247 procedures were calculated, organized into 18 groups, for three periods - year before the pandemic (YBP) and first (YP1) and second (YP2) years of the pandemic. Through the online form, information was collected on: operation and organization of services; post-covid-19 rehabilitation; actions to support the needs of users and professionals; strategies and challenges experienced.

Results: There was a 33.3% reduction in the total number of procedures in YP1 compared to YBP. There were no reductions in procedures performed by nurses and for ostomates. There was greater impairment for group activities, visual therapies and home visits. In YP2, there was a recovery of averages in relation to YBP in 11 groups of procedures, with an increase of 104.1% in Cardiorespiratory Physiotherapy. In the answers to the online form, 91.7% of the managers indicate structural and/or organizational changes in the CER, such as: creation of prioritization criteria for assistance; introduction of telerehabilitation; changes in the work process and; provision of professional training. Half of the CER already treated people with covid-19 sequelae, but not all of them had been trained to do so. Limitations in participation and social support for PWD were identified.

Conclusions: There was a severe impact of the covid-19 pandemic on the CER. Added to the damming up of previous demands are those of post-covid-19 users, configuring a challenging picture. It is necessary to strengthen the Care Network for Persons with Disabilities, with expansion and greater integration of services and a more inclusive organization to overcome these challenges.

OBJETIVO: Analisar o impacto da pandemia de covid-19 no funcionamento dos Centros Especializados em Reabilitação (CER) no SUS.

MÉTODOS: Realizou-se análise da variação da produção ambulatorial dos CER com base nos dados do Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA-SUS) no período de março de 2019 a dezembro de 2021. Tais resultados foram cotejados com as percepções de gestores de CER acerca dos impactos da pandemia nas unidades, aferidas por websurvey aplicado entre novembro de 2020 e fevereiro de 2021. Foram calculadas as médias mensais de 247 procedimentos, organizados em 18 grupos, para três períodos – ano anterior à pandemia (APP), primeiro (AP1) e segundo (AP2) anos de pandemia. Por meio do formulário on-line foram coletadas informações sobre: funcionamento e organização dos serviços; reabilitação pós-covid-19; ações de apoio às necessidades de usuários e profissionais; estratégias e desafios vivenciados.

RESULTADOS: Houve redução de 33,3% do total de procedimentos em AP1 em relação a APP. Não foram reduzidos procedimentos realizados por enfermeiros e para pessoas ostomizadas. Ocorreu maior prejuízo para atividades em grupo, terapias visuais e visitas domiciliares. Em AP2, houve recuperação das médias em relação a APP em 11 grupos de procedimentos, com aumento de 104,1% de Fisioterapia Cardiorrespiratória. Nas respostas ao formulário on-line, 91,7% dos gestores indicam mudanças estruturais e/ou organizacionais nos CER como: criação de critérios de priorização para atendimentos; introdução de telerreabilitação; modificações no processo de trabalho e; disponibilização de capacitações profissionais. Metade dos CER já atendiam pessoas com sequelas de covid-19, mas nem todos haviam sido instrumentalizados para tanto. Identificaram-se limitações na participação e no suporte social para PCD.

CONCLUSÕES: Houve severo impacto da pandemia de covid-19 nos CER. Ao represamento de demandas prévias se somam aquelas de usuários pós-covid-19, configurando um quadro desafiador. Faz-se necessário fortalecimento da Rede de Cuidados à Pessoa com Deficiência, com ampliação e maior integração dos serviços e organização mais inclusiva para a superação desses desafios.

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Conflict of interest statement

Conflict of Interests: The authors declare that there is no conflict of interest.

Figures

Figure
Figure. Managers’ perception of how much the activities carried out in the CER were affected by the Covid-19 pandemic. Brazil, 2021.
Figura
Figura. Percepção dos gestores sobre quanto as atividades realizadas nos CER foram afetadas pela pandemia de Covid-19. Brasil, 2021.
See this image and copyright information in PMC

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