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】 背景：烧伤是人群中高发的健康问题，可波及各年龄段与社会阶层的人群，病情严重程度存在差异，涉及不同层级的医疗照护需求。2000年，巴西卫生部确立了组建专门收治高复杂性烧伤患者的州级烧伤中心的规划。 目的：医疗照护网络的布局与运行可影响人群的健康-疾病进程，统筹患者就医流转路径，尤其在巴西公共卫生系统（SUS）中，能够强化区域化、层级化照护网络的运行逻辑。 方法：本文针对2013年1月至2015年12月间巴西米纳斯吉拉斯州内SUS体系下的重度烧伤患者就医流转路径进行了映射分析。 结果：该州有10个卫生宏观区域无法独立承担辖区内患者的住院收治工作。其中，以州府贝洛奥里藏特为核心的中部卫生宏观区域，是全州烧伤患者照护的核心支撑网络。北部卫生宏观区域则是契合SUS区域化建设指南的照护网络标杆范例。 结论：本研究明确了米纳斯吉拉斯州烧伤照护资源分布存在的短板，指出亟需投入资源建设布局均衡的区域烧伤救治中心，以填补现有服务缺口。