0391/2020 - Contingência hospitalar no enfrentamento da covid-19 no Brasil: Problemas e alternativas governamentais Hospital contingency in coping with covid-19 in Brazil: Governmental problems and alternatives
Este artigo analisa a agenda governamental estratégica para enfrentamento da COVID-19 no Brasil, com foco na atenção hospitalar. Foram analisados28 Planos de Contingência na íntegra, sendo 01 nacional, 26 estaduais e 01 do Distrito Federal. Utilizou-se o referencial teórico do Ciclo da Política Pública, especificamente os momentos de pré-decisão e decisão governamentalpara o enfrentamento da pandemia. As evidências revelaram convergências entre os níveis nacional e estaduais quanto às propostas de reorientação do fluxo de atendimento, detecção dos casos e indicação de hospitais de referência. Todavia, as agendas estaduais demonstraram fragilidadescorrelacionadas à aquisição de aparelhos de ventilação mecânica, dimensionamento de recursos humanos, regionalização da atenção hospitalar, além de poucos estados terem estabelecido um método de cálculo de leitos de retaguarda,principalmente quanto aprevisão de abertura de hospitais de referência ou contratação complementar de leitos de UTI. Conclui-se que a heterogeneidade de ações explicitadas nos planos revelaa complexidade do processo de enfrentamento da COVID-19 no Brasil com suas desigualdades regionais, fragilidades dos sistemas estaduais de saúde e reduzida coordenação do Ministério da Saúde.
Palavras-chave:
Coronavírus; Sistema Único de Saúde;Hospitais;Número de Leitosem Hospital;Planos de Contingência
Abstract:
This article analyzes the government\'s strategic agenda for coping with COVID-19 in Brazil, focusing on hospital care. 28 Contingency Plans were analyzed in full, 01 national, 26 state and 01the Federal District. The theoretical framework of the Public Policy Cycle was used, specifically the moments of pre-decision and government decision to face the pandemic. The evidence revealed convergences between the national and state levels in terms of proposals for reorienting the flow of care, case detection and referral hospitals. However, the state agendas showed weaknesses related to the acquisition of mechanical ventilation devices, dimensioning of human resources, regionalization of hospital care, in addition to the fact that few states have established a method for calculating back beds, mainly regarding the forecast of opening hospitals in reference or complementary contracting of ICU beds. It is concluded that the heterogeneity of actions explained in the plans reveals the complexity of the process of coping with COVID-19 in Brazil with its regional inequalities, weaknesses in the state health systems and reduced coordination by the Ministry of Health.
Keywords:
Coronavirus;Unified Health Systems; Hospitals; Hospital bed capacity; Contingency Plans
Hospital contingency in coping with covid-19 in Brazil: Governmental problems and alternatives
Resumo (abstract):
This article analyzes the government\'s strategic agenda for coping with COVID-19 in Brazil, focusing on hospital care. 28 Contingency Plans were analyzed in full, 01 national, 26 state and 01the Federal District. The theoretical framework of the Public Policy Cycle was used, specifically the moments of pre-decision and government decision to face the pandemic. The evidence revealed convergences between the national and state levels in terms of proposals for reorienting the flow of care, case detection and referral hospitals. However, the state agendas showed weaknesses related to the acquisition of mechanical ventilation devices, dimensioning of human resources, regionalization of hospital care, in addition to the fact that few states have established a method for calculating back beds, mainly regarding the forecast of opening hospitals in reference or complementary contracting of ICU beds. It is concluded that the heterogeneity of actions explained in the plans reveals the complexity of the process of coping with COVID-19 in Brazil with its regional inequalities, weaknesses in the state health systems and reduced coordination by the Ministry of Health.
Palavras-chave (keywords):
Coronavirus;Unified Health Systems; Hospitals; Hospital bed capacity; Contingency Plans
