O diagnóstico por imagem na alta complexidade no Brasil: uma análise espaço-temporal

Abstract

The aim of the present study was to evaluate the tendency of spending per capita with diagnosis of high complexity image and the relationship with demographic, socioeconomic and structural variables in Brazil. Methods: The intrinsic predictability of ecological time series using the records of the information systems of the Unified Health System in the period from 2008 to 2017, by administrative areas defined by the ministries of health. Analyzes were performed by Pearson's correlation, to verify the degree of association between expenditure and the variables Gross Domestic Product per capita, population, physician-presence Rate, rate of equipment in use in Unified Health System and coverage by the Family Health Strategy. In addition, the regression with Generalized Linear Models with Mixed Effects was also performed. Results: There was an increase in expenses with high-complexity image diagnosis during the study period, and a positive association with the variables Gross Domestic Product per capita, rate of doctors, rate of equipment in use in SUS and negative with coverage by the strategy family Health. The greatest influence on the increase in spending was attributed to the variables rate of doctors and Gross Domestic Product per capita, and reduction of spending in regions with greater coverage by the Family Health Strategy. Conclusion: Despite the expenses with diagnosis of high complexity images still being concentrated in the macro-regions with better socioeconomic indicators, the present study pointed to a distribution with less inequality in the years. The relationship between the expansion of the coverage of the Family Health Strategy and the decrease in spending, showed itself as an important indicator in the direction of public policies and resources, when drawing an overview of spending in the regions.