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：烧伤是普通人群中的高发健康问题，可累及各年龄段及各社会阶层人群。烧伤伤情的轻重差异，对应着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重症复杂烧伤患者的州级烧伤救治中心的规范。
研究目的：医疗照护网络的布局会影响人群的健康-疾病进程，统筹患者就医流转流程，尤其在巴西公共卫生体系（Sistema Único de Saúde，SUS）中，该布局强化了区域化、层级化医疗照护网络的运行逻辑。
方法：本研究针对2013年1月至2015年12月期间，巴西米纳斯吉拉斯州内纳入SUS体系的重度烧伤患者的就医流转情况进行了系统梳理与分析。
结果：共有10个卫生宏观区域无法独立承担辖区内烧伤患者的住院照护需求。其中以贝洛奥里藏特市为核心的中部卫生宏观区域，是全州烧伤患者救治的重要依托网络；北部卫生宏观区域则是符合SUS区域化指导原则的医疗网络标杆范例。
结论：本研究明确了全州烧伤救治资源分布存在的短板，并提出需加大投入，在米纳斯吉拉斯州内布局分布均衡的烧伤救治区域参考中心。