0367/2024 - Análise da implementação da atenção pré-hospitalar e hospitalar a casos de acidentes e violências no Brasil Analysis of the implementation of pre-hospital and hospital care for cases of accidents and violence in Brazil
Acidentes e violências exigem atenção à saúde em diversos níveis. Analisou-se a implementação de duas diretrizes da Política Nacional de Redução da Morbimortalidade por Acidentes e Violências (PNRMAV) referentes à atenção pré-hospitalar (APH) e hospitalar (AH). Gestores de APH e AH dos municípios brasileiros participaram de estudo transversal (2020-2022), respondendo a questionário via plataforma Redcap. Foram realizadas análises descritivas e comparativas. A taxa de resposta foi de 2,3% dos municípios (n=128), incluindo nove capitais. Essas apresentaram melhores resultados nos itens avaliados. Na APH móvel, 82,8% dos municípios e 100% das capitais utilizam transporte próprio para pacientes. Nas capitais, os serviços recebem e encaminham mais os casos intersetorialmente (valor-p<0,05). Na AH, as capitais fazem mais uso de protocolos (p=0,008) e 40% dos gestores consideram os leitos adequados às necessidades. A implementação da diretriz da PNRMAV que trará da Sistematização do atendimento pré-hospitalar foi boa em 59,4% municípios e 77,8% das capitais, enquanto a de assistência interdisciplinar às vítimas foi regular em 45,1% dos municípios e boa em 75% das capitais. Apesar dos avanços na implementação da PNRMAV, é necessário fortalecer as redes de atenção a urgência e emergência e otimizar os recursos disponíveis.
Palavras-chave:
Acidentes, Violência, Política de saúde
Abstract:
Accidents and violence require health care at different levels. The implementation of two guidelines of the National Policy for Reducing Morbidity and Mortality from Accidents and Violence (PNRMAV) regarding pre-hospital care (APH) and hospital care (AH) was analyzed. APH and AH managers from Brazilian municipalities participated in a cross-sectional study (2020-2022), answering a questionnaire via the Redcap platform. Descriptive and comparative analyses were performed. The response rate was 2.3% of the municipalities (n=128), of which 9 were capitals. Capitals presented better results in all items evaluated. In mobile APH, 82.8% of the municipalities and 100% of the capitals use their own transportation for patients. In the capitals, the services receive and refer more cases intersectoral (p-value<0.05). In AH, the capitals make greater use of protocols (p=0.008) and 40% of managers consider the beds adequate for the needs. The implementation of the Systematization of pre-hospital care guideline was good for 59.4% of the municipalities and 77.8% of the capitals, while the Interdisciplinary Assistance to Victims guideline was regular in 45.1% of the municipalities and good in 75% of the capitals. Despite the advances in the implementation of the PNRMAV, it is necessary to strengthen the emergency care networks and optimize the available resources.
Analysis of the implementation of pre-hospital and hospital care for cases of accidents and violence in Brazil
Resumo (abstract):
Accidents and violence require health care at different levels. The implementation of two guidelines of the National Policy for Reducing Morbidity and Mortality from Accidents and Violence (PNRMAV) regarding pre-hospital care (APH) and hospital care (AH) was analyzed. APH and AH managers from Brazilian municipalities participated in a cross-sectional study (2020-2022), answering a questionnaire via the Redcap platform. Descriptive and comparative analyses were performed. The response rate was 2.3% of the municipalities (n=128), of which 9 were capitals. Capitals presented better results in all items evaluated. In mobile APH, 82.8% of the municipalities and 100% of the capitals use their own transportation for patients. In the capitals, the services receive and refer more cases intersectoral (p-value<0.05). In AH, the capitals make greater use of protocols (p=0.008) and 40% of managers consider the beds adequate for the needs. The implementation of the Systematization of pre-hospital care guideline was good for 59.4% of the municipalities and 77.8% of the capitals, while the Interdisciplinary Assistance to Victims guideline was regular in 45.1% of the municipalities and good in 75% of the capitals. Despite the advances in the implementation of the PNRMAV, it is necessary to strengthen the emergency care networks and optimize the available resources.
Ribeiro, A.P, Oliveira, G.L, Silveira, A.M, Avanci, J.Q. Análise da implementação da atenção pré-hospitalar e hospitalar a casos de acidentes e violências no Brasil. Cien Saude Colet [periódico na internet] (2024/nov). [Citado em 08/04/2025].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/analise-da-implementacao-da-atencao-prehospitalar-e-hospitalar-a-casos-de-acidentes-e-violencias-no-brasil/19415?id=19415
