Cenário para o cuidado à pessoa idosa com demência na atenção primária à saúde da macrorregião sudeste de Minas Gerais: estudo transversal

Abstract

Objective: To describe the demographic and healthcare structure of Primary Health Care in the Southeast Minas Gerais Health Macroregion with regard to its potential for providing healthcare to older adults with dementia. Methodology: An epidemiological, observational, cross-sectional, and descriptive study using a quantitative approach, focusing on the following variables: demographic; health care; morbidity and mortality; and the number of Primary Health Care facilities, teams, and professionals in the 94 municipalities comprising the nine micro-regional hubs of the Southeast Minas Gerais Health Macroregion, for the years 2024 and 2025. Data collection was conducted using the information systems of the Brazilian Institute of Geography and Statistics (2022 Census); the National Registry of Health Facilities; the Mortality Information System and Hospital Information System (DATASUS); and e-Gestor AB, with findings validated by key informants. The analysis was performed using SPSS version 21, employing the following tests: Shapiro-Wilk, Kruskal-Wallis, one-way ANOVA, and the Post Hoc LSD method for variables with p < 0.05, with a 95% confidence level and simple data cross-tabulation. Results: Minas Gerais is the third state with the highest proportion of older adults, comprising 324,353 older adults (20.3%). Analyzing the distribution of Primary Health Care infrastructure by micro-region population, the rate of Family Health Strategy professionals (p<0.01) as well as the rate of outpatient care for the elderly (p<0.05) stand out, with a higher allocation of professionals and a difference in the volume of care across micro-regions. A higher percentage of Family Health teams was observed (57.71%), followed by Oral Health teams (29%), Multidisciplinary teams (8.2%), Primary Care teams (2.7%), teams associated with the Health Academy program (2%), and Street Clinic teams (0.4%). Of the 6,906 professionals registered on a team, 62.4% of this group were registered as Family Health professionals. The average mortality rate for the Southeast Minas Gerais Health Macroregion was 10.4 (SD 2.7; min. 5.1; max. 19.5). There was a significant difference between the rates of the micro-regions (p<0.05), and the Post Hoc LSD test identified a difference in the average mortality rate of the Muriaé micro-region, which was lower than the overall average. Regarding morbidity and mortality, between January 2024 and June 2025, there were 324 hospitalizations due to dementia and Alzheimer’s disease, along with 102 deaths (32.7%) attributable to the same conditions. Conclusion: A potentially robust care structure was identified for the care of older adults with dementia. However, the unequal distribution of human resources and care infrastructure still poses significant challenges to the effectiveness of comprehensive and longitudinal care.