Impact of the COVID-19 pandemic on the performance of pediatricians and pediatric dentists in the Brazilian Unified Health System
Article Sidebar
Main Article Content
Abstract
Objective: To evaluate the impact of the COVID-19 pandemic on the outpatient production of pediatricians and pediatric dentists in the Brazilian Unified Health System (SUS). Methods: An ecological study was carried out with an analytical and quantitative approach, using public domain data from the Department of Informatics of the SUS. The monthly number of professionals who worked in the SUS, the number of outpatient procedures in each category and the projection of residents from zero to thirteen years old to normalize it were retrieved. Data were compared by pre-pandemic (2018-2020) and pandemic (2020-2022) periods with a significance level of 5%. Results: There was a significant reduction in the monthly number of outpatient procedures performed in the SUS by pediatricians in the first and second pandemic year of COVID-19 when compared to the pre-pandemic period (p <0.001 e 0.002, respectively). This reduction represents a median percentage reduction of -57.1% (CI95% -51.3%, -71.7%) in the first and -22.3% (CI95% -0.55%, -31.5%) in the second pandemic year. Regarding pediatric dentists, a significant reduction was observed only between the pre-pandemic period and the first pandemic year (p <0.001), representing -82.0% (CI95% -73.4%, -93.6%). Moreover, a significant, positive and moderate correlation was observed between the productivity of both professional categories in the SUS throughout the investigated period (p < 0.001, ρ = 0.744). Conclusion: The COVID-19 pandemic negatively affected the provision of specialized medical and dental outpatient care for children in the SUS.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors maintain copyright and grant the HSJ the right to first publication. From 2024, the publications wiil be licensed under Attribution 4.0 International 
, allowing their sharing, recognizing the authorship and initial publication in this journal.
Authors are authorized to assume additional contracts separately for the non-exclusive distribution of the version of the work published in this journal (e.g., publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
Authors are encouraged to publish and distribute their work online (e.g., in institutional repositories or on their personal page) at any point after the editorial process.
Also, the AUTHOR is informed and consents that the HSJ can incorporate his article into existing or future scientific databases and indexers, under the conditions defined by the latter at all times, which will involve, at least, the possibility that the holders of these databases can perform the following actions on the article.
References
2. Rosa MFF, da Silva EN, Pacheco C, Diógenes MVP, Millett C, Gadelha CAG, et al. Direct from the COVID-19 crisis: research and innovation sparks in Brazil. Health Res Policy Syst. 2021;19(1):10. https://doi.org/10.1186/s12961-020-00674-x
3. Zimmermann IR, Sanchez MN, Alves LC, Frio GS, Cavalcante FV, Cortez-Escalante JJ, et al. COVID-19 as the leading cause of hospital deaths in the Brazilian public health system in 2020. Int J Infect Dis. 2021;113:162-165. https://doi.org/10.1016/j.ijid.2021.09.077
4. Frio GS, Russo LX, de Albuquerque CP, da Mota LMH, Barros-Areal AF, Oliveira APRA, et al. The disruption of elective procedures due to COVID-19 in Brazil in 2020. Sci Rep. 2022;12(1):10942. https://doi.org/10.1038/s41598-022-13746-5
5. Martin BI, Brodke DS, Wilson FA, Chaiyakunapruk N, Nelson RE. The impact of halting elective admissions in anticipation of a demand surge due to the coronavirus pandemic (COVID-19). Med Care. 2021;59(3):213-19. https://doi.org/10.1097/MLR.0000000000001496
6. Balasubramanian S, Rao NM, Goenka A, Roderick M, Ramanan AV. Coronavirus disease 2019 (COVID-19) in children - what we know so far and what we do not. Indian Pediatr. 2020;57(5):435-42. https://doi.org/10.1007/s13312-020-1819-5
7. Phillips DE, Bhutta ZA, Binagwaho A, Boerma T, Freeman MC, Hirschhorn LR, et al. Learning from exemplars in Global Health: a road map for mitigating indirect effects of COVID-19 on maternal and child health. BMJ Glob Health. 2020;5(7):e003430. https://doi.org/10.1136/bmjgh-2020-003430
8. Sharfstein JM. Child Health Policy and the COVID-19 pandemic. JAMA Health Forum. 2021;2(8):e212921. https://doi.org/10.1001/jamahealthforum.2021.2921
9. Cabral IE, Pestana-Santos M, Ciuffo LL, Nunes YDR, Lomba MLLF. Child health vulnerabilities during the COVID-19 pandemic in Brazil and Portugal. Rev Lat Am Enfermagem. 2021;29:e3422. https://doi.org/10.1590/1518-8345.4805.3422
10. Gur-Arie R, Johnson S, Collins M. Advancing child health and educational equity during the COVID-19 pandemic through science and advocacy. Isr J Health Policy Res. 2022;11(1):3. https://doi.org/10.1186/s13584-021-00512-7
11. Merchán-Hamann E, Tauil PL. Proposal for classifying the different types of descriptive epidemiological studies. Epidemiol Serv Saude. 2021;30(1):e2018126. https://doi.org/10.1590/s1679-49742021000100026
12. Brasil. Resolução n. 510 de 7 de abril de 2016 [Internet]. Dispõe sobre as normas aplicáveis a pesquisas em ciências humanas e sociais. Diário Oficial da União; Brasília: 24 May 2016. Available from: https://conselho.saude.gov.br/resolucoes/2016/Reso510.pdf
13. Barros SG, Chaves SCL. Use of the outpatient information system (SIA-SUS) to assess oral health activities. Epidemiol Serv Saude. 2003;12(1):41-51. https://doi.org/10.5123/S1679-49742003000100005
14. dos Santos MBF, Pires ALC, Saporiti JM, Kinalski MA, Marchini L. Impact of COVID-19 pandemic on oral health procedures provided by the Brazilian public health system: COVID-19 and oral health in Brazil. Health Policy Technol. 2021;10(1):135-42. https://doi.org/10.1016/j.hlpt.2021.02.001
15. Antunes JLF, Cardoso MRA. Using time series analysis in epidemiological studies. Epidemiol Serv Saude. 2015;24(3):565-76. https://doi.org/10.5123/S1679-49742015000300024
16. Daltro MR, Guerra-Júnior P, Alves PCL. Experience of a pediatrician in combating COVID-19: an autobiographical narrative. Res Soc Dev. 2021;10(16):e09101622940. https://doi.org/10.33448/rsd-v10i16.22940
17. Carvalho LIM, da Silva TVS, Castanha DM, Galdino LMB, Silva ADCM, Costa GB, et al. Pediatric dentistry and COVID-19: the reflection of the pandemic on care in Paraíba. Braz J Develop. 2021;7(11):109033-4. https://doi.org/10.34117/bjdv7n11-501
18. Braga BR, Amorim-Júnior LA, Castro CG, Corrêa-Farias P. Mudanças no atendimento odontopediátrico e uso de procedimentos de mínima intervenção durante a pandemia de COVID-19. Rev Odontol Bras Central. 2022;31(90):105-20. https://doi.org/10.36065/robrac.v31i90.1557
19. Asociación Latinoamericana de Odontopediatría. Equipo Interdisciplinario COVID-. Pediatric dentistry management guidelines during the confinement or quarantine stage of the COVID-19 pandemic. Rev Odotopediatr Latinoam. 2020;10(2):131-82.
20. Santos ACS, Santos EM, Bussadori SK, Imparato JCP, Rezende KM. Food in the pandemic - how this issue affected children's oral health: a narrative review of the literature. Res Soc Dev. 2021;10(12):e461101220679. https://doi.org/10.33448/rsd-v10i12.20679
21. Felipe LP, Silva MJN, Vasconcelos PF, Leite ACRM, Melo ESJ, Nogueira MRN. Impacts of the COVID-19 pandemic on child care and oral health from parents' perspective. Rev Enferm Atual In Derme. 2022;96(38):e-021247. https://doi.org/10.31011/reaid-2022-v.96-n.38-art.1375
22. Cardoso PC, Sousa TM, Rocha DS, Menezes LRD, Santos LC. Maternal and child health in the context of COVID-19 pandemic: evidence, recommendations and challenges. Rev Bras Saúde Matern Infant. 2021;21(Supl. 1):S213-20. https://doi.org/10.1590/1806-9304202100s100011
23. Morais AC, Miranda JOF. Repercussions of the pandemic on the health of Brazilian children beyond COVID-19. Physis. 2021;31(1):e310102. https://doi.org/10.1590/s0103-73312021310102
24. Santos IC, Oliveira LMF, Salas MMS, Soares MRPS, Dias AM. Dental education, teledentistry and the COVID-19 pandemic: a narrative review. Res Soc Dev. 2022;11(12):e436111234619. https://doi.org/10.33448/rsd-v11i12.34619
25. Bolognese D, Dianin AH, Cavazana WC. Telemedicine platform for outpatient and emergency care during the COVID-19 pandemic. Res Soc Dev. 2022;11(11):e290111133024. https://doi.org/10.33448/rsd-v11i11.33024
26. Naseri A, Hosseini MS. Do not neglect the children: considerations for COVID-19 pandemic. Indian Pediatr. 2020;57(6):583-4. https://doi.org/10.1007/s13312-020-1868-9
27. Wong CA, Ming D, Maslow G, Gifford EJ. Mitigating the impacts of the COVID-19 pandemic response on at-risk children. Pediatrics. 2020;146(1):e20200973. https://doi.org/10.1542/peds.2020-0973
28. Campos MR, Schramm JMA, Emmerick ICM, Rodrigues JM, Avelar FG, Pimentel TG. Burden of disease from COVID-19 and its acute and chronic complications: reflections on measurement (DALYs) and prospects for the Brazilian Unified National Health System. Cad Saude Publica. 2020;36(11):e00148920. https://doi.org/10.1590/0102-311x00148920
29. Gleriano JS, Fabro GCR, Tomaz WB, Goulart BF, Chaves LDP. Reflections on the management of Brazilian Unified Health System for the coordination in facing COVID-19. Esc Anna Nery Rev Enferm. 2020;24:e20200188. https://doi.org/10.1590/2177-9465-ean-2020-0188