Os impactos do Escore Unificado de Priorização (EUP) na regulação do acesso aos leitos do Sistema Único de Saúde (SUS) brasileiro: um estudo durante a pandemia de Covid-19 no Estado do RN no Brasil

Abstract

The World Health Organization (WHO) declared on January 30, 2020, the highest level of global health alert provided for in the International Health Regulations (IHR), the so-called Public Health Emergency of International Concern (PHEIC), due to the COVID-19 epidemic. The COVID-19 pandemic can be portrayed as one of the greatest outbreaks in human history. The detection and spread of an emerging respiratory pathogen were accompanied by uncertainties regarding the main epidemiological, clinical, and virological characteristics of this new pathogen, particularly its ability to spread within the human population and its virulence (severity of the case). In Rio Grande do Norte (RN), a Brazilian state, RegulaRN was the regulation platform used to manage, with equity, the access of COVID-19 patients to public hospitals. Thus, this study presents results obtained by incorporating the Unified Prioritization Protocol (EUP) as an objective criterion for the regulation of Intensive Care Unit (ICU) beds in the RN's Unified Health System (SUS). The methodological process involved a selection of days before and after the use of the EUP as a prioritization mechanism, followed by an evaluation of the correlation between the score, length of stay, and the regulation outcome. The research revealed that using the EUP as a parameter for patient prioritization resulted in a significant reduction in ICU length of stay. This result is crucial as it increases bed turnover, enabling a more efficient use of available resources. Moreover, the analysis showed that the adoption of the EUP contributed to a more accurate classification of patients based on the severity of their clinical condition. This facilitated a fairer and more data-driven allocation of beds, reducing the influence of subjective interpretations by healthcare professionals. Therefore, it can be concluded that the implementation of the EUP in the regulation protocol of the RegulaRN Platform can lead to greater efficiency in bed management processes, promoting a better response to the population's healthcare needs. The research suggests that by adopting objective criteria such as the EUP, the healthcare system can significantly improve the quality and equity of care, optimizing the use of available resources.