Care flows of moderate and severe burned patients in regions and health care networks of Minas Gerais

Abstract Background Burns, a problem of high incidence in the general population, reach people of all ages and social levels. Severity variation involves care at all levels of care. In 2000, the Brazilian Ministry of Health determined the organization of state burn centers specialized in the assistance of high complexity burns. Objective The configuration of care networks influences the health-disease process of the populations, organizes the flow of patients in the search for care, especially in the public system (SUS), reinforcing the logic of regionalized and hierarchical networks of care. Method This article mapped the flow of patients with severe burns under SUS, in the state of Minas Gerais, from January 2013 to December 2015. Results Ten macro-regions of health were not self-sufficient in the hospitalizations of their patients. The macro-region Center, city of Belo Horizonte, stood out as an important assistance network to the burned patient in the state. The North Macro-region was the best example of a network according to the SUS regionalization guidelines. Conclusion The study identified gaps in the distribution of assistance and pointed to the need for investments to create reference centers with equitable distribution in the state of Minas Gerais.

摘要
## 研究背景
烧伤是普通人群中的高发健康问题，可波及各年龄段与社会阶层的人群，病情严重程度的差异对应各级医疗照护需求。2000年，巴西卫生部启动了州级烧伤中心的组建工作，该中心专门收治高复杂性烧伤患者。
## 研究目的
医疗照护网络的构建会影响人群的健康-疾病进程，规范患者就医转诊流程，尤其在巴西统一卫生系统（SUS）中，可强化区域化、层级化医疗照护网络的运行逻辑。
## 研究方法
本文针对2013年1月至2015年12月期间，米纳斯吉拉斯州（Minas Gerais）内纳入巴西统一卫生系统（SUS）的重度烧伤患者的转诊流程开展了映射分析。
## 研究结果
全州有10个卫生大辖区无法实现辖区内烧伤患者住院治疗的自给自足。其中以贝洛奥里藏特市（Belo Horizonte）为核心的中部卫生大辖区，是全州烧伤患者医疗照护的核心枢纽网络。北部卫生大辖区则是契合SUS区域化指南的最优医疗网络范本。
## 研究结论
本研究明确了米纳斯吉拉斯州烧伤医疗照护资源分布存在的短板，并指出需投入资源建立分布均衡的烧伤转诊参考中心，以优化全州烧伤医疗服务体系。