Efeitos da pandemia de COVID-19 na atenção à hipertensão arterial sistêmica e diabetes mellitus na Estratégia Saúde da Família (ESF) no município de Macaé em 2020

Abstract

Chronic non-communicable diseases (NCDs) are one of the main causes of mortality and disability, with a significant impact on public health and the economy. Among them, systemic arterial hypertension (SAH), a relevant risk factor for cardiovascular diseases, and diabetes mellitus (DM), considered the most prevalent comorbidity causing functional impairment and chronic complications, are the main comorbidities. During the COVID-19 pandemic, access to diagnosis and follow-up of these diseases has been limited, intensifying challenges in the prevention and control of NCDs. Primary Health Care (PHC) has emerged as essential to mitigating these impacts and reducing associated morbidity and mortality, with the Family Health Strategy (FHS) as its main policy and gateway to the system. In this context, this dissertation sought to assess the effects of the COVID-19 pandemic on care for SAH and DM in the ESFs in Macaé, RJ, during 2020. The main objective is to understand how the pandemic has impacted the detection of new cases and the follow-up of these patients through an exploratory and analytical ecological study of time trends, comparing data between the pre-pandemic period (2017-2019) and the pandemic year (2020). Secondary data extracted from the e-SUS PEC PHC information system was analyzed. Based on the number of patients with SAH and/or DM registered and monitored and the number of daily consultations of these patients at the FHSs in Macaé, the following were calculated the indicators of number of consultations per day, number of consultations per registered patient and number of daily consultations per registered patient were calculated. Based on the statistical analysis carried out using the Joinpoint model, a change was detected in the trends of the indicators during the period analyzed, with monthly and annual percentage variations being considered significant (p < 0.05). The results showed a significant impact on SAH and DM care. The pandemic resulted in a 27.34% drop in SAH consultations and a 33.49% drop in DM consultations during critical months, such as March and April 2020. This decline may be a reflection of changes in the flow of care and the prioritization of COVID-19 cases, as well as the population's fear of seeking health services in the pandemic context. Palliative strategies, such as home delivery of medication and health education for self-care, have been adopted, but have not completely compensated for the reduction in follow-up. The conclusion is that the pandemic has had significant adverse effects on the continuity of care for patients with SAH and DM, highlighting the need for public policies that strengthen care for chronic diseases in times of crisis. It also highlights the importance of preparing PHC to respond to health emergencies, in order to minimize the impact on the health of vulnerable populations.