ACCESS TO ONCOLOGIC SERVICES IN THE CONTEXT OF THE BRAZILIAN NATIONAL HEALTH SYSTEM: ECOLOGICAL STUDY

Introduction: Cancer represents a public health problem in the world and is among the four main causes of premature death, before 70 years of age. The extended access to health services for cancer patients is a consequence of the expansion of oncologic care, but some situations can affect this expansion and, consequently, the access to health services and the therapeutic chain. Objective: To analyze the accessibility of oncologic patients to specialized services through data from the Geographic Information System and network methodology. Methods: This is an ecological time-series study in which information was collected from databases made available by the Brazilian National Cancer Institute and by the SUS Department of Informatics (DATASUS; http://www.datasus.gov.br), regarding the Hospital Information SubSystem (SIH-SUS), as well as data from the SUS Outpatient Information System (SIA-SUS), a highly complex module for oncologic care (APAC/ONCO), throughout Brazil. The search took place between May and June 2021, where the time frame corresponded to the last five years. The variables analyzed using descriptive statistics were: number of consultations, oncologic surgeries accomplished, diagnostic tests and home care Results: It is evidenced, through the data, that health services are broadly distributed throughout Brazil, but it is clear that some centers gather such services corresponding to 65.3% of the services, and that 39.1% of these services have a shortage of care at the expense of demand. In centers where health management is conducted in the form of networks, services are much more divided by sectors and the shortage to the detriment of demand falls 15.4%. In those places that have difficulty of access because of demographics, the network system contributes 11.4% to the amplification of services. Conclusion: It is necessary to reformat and realign the health service for health promotion, disease prevention and early diagnosis, where the health networks composed of lines of care are one of the ways to drive these changes.