Outpatient Physiotherapy Production in the Capitals and Units of the Federation Of Brazil, 2019-2023: Descriptive Study
DOI:
https://doi.org/10.36489/saudecoletiva.2025v15i95p15818-15835Keywords:
Secondary health care, Physiotherapy services, Secondary data analysis, Health care disparities, Health information systemsAbstract
Objective: To analyze the percentage of outpatient physiotherapy production between 2019 and 2023 in the federative units and state capitals of Brazil. Methods: This is an observational study that analyzed the percentage of outpatient physiotherapy production between 2019 and 2023 in the 27 federative units and state capitals of Brazil. Results: Brazilian outpatient physiotherapy production decreased in the first years of the pandemic, in 2020 and 2021. Compared to 2019, 26 federative units and 25 capitals suffered a drop in production in 2020, with only Pará, Belém, and Fortaleza not facing a reduction. Most federative units and capitals managed to recover between 2022 and 2023, and maintained their production higher than pre-pandemic values. Conclusion: Public outpatient physiotherapy was subject to several limitations that reduced its production in the period evaluated.
References
World Health Organization. 2020 [cited 2024 Sep 22]. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Available from: https://www.who.int/news/item/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)
Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021 Mar 16;11(3):e045343.
World Health Organization. Pulse survey on continuity of essential health services during the COVID-19 pandemic. Geneva; 2020 Aug.
Dupraz J, Le Pogam MA, Peytremann-Bridevaux I. Early impact of the COVID-19 pandemic on in-person outpatient care utilisation: a rapid review. BMJ Open. 2022 Mar 3;12(3):e056086. DOI: https://doi.org/10.1136/bmjopen-2021-056086
Ministério da Saúde. PORTARIA No 188, DE 3 DE FEVEREIRO DE 2020. Brasília: Ministério da Saúde; Feb 4, 2020.
Ministério da Saúde. PORTARIA No 913, DE 22 DE ABRIL DE 2022. Brasília: Ministério da Saúde; Apr 22, 2022.
Fundação Oswald Cruz. O “represamento” do atendimento em saúde no SUS Destaques [Internet]. 2021 Nov. Available from: https://covid.saude.gov.br/
Antony Leo Asser P, Soundararajan K. The vital role of physiotherapy during COVID-19: A systematic review. Vol. 70, Work. IOS Press BV; 2021. p. 687–94. DOI: https://doi.org/10.3233/WOR-210450
Moynihan R, Sanders S, Michaleff ZA, Scott AM, Clark J, To EJ, et al. Impact of COVID-19 Pandemic on Utilisation of Healthcare services: a Systematic Review. BMJ Open [Internet]. 2021 Mar 1;11(3):e045343. Available from: https://bmjopen.bmj.com/content/11/3/e045343 DOI: https://doi.org/10.1136/bmjopen-2020-045343
Machado AV, Ferreira WE, Vitória MA de Á, Magalhães Júnior HM, Jardim LL, Menezes MAC, et al. COVID-19 and health systems in Brazil and around the world: effects on the working conditions and health of health workers. Ciencia e Saude Coletiva. 2023;28(10):2965–78. DOI: https://doi.org/10.1590/1413-812320232810.10102023en
Haldane V, De Foo C, Abdalla SM, Jung AS, Tan M, Wu S, et al. Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries. Vol. 27, Nature Medicine. Nature Research; 2021. p. 964–80. DOI: https://doi.org/10.1038/s41591-021-01381-y
Arsenault C, Gage A, Kim MK, Kapoor NR, Akweongo P, Amponsah F, et al. COVID-19 and resilience of healthcare systems in ten countries. Nat Med. 2022 Jun 1;28(6):1314–24. DOI: https://doi.org/10.1038/s41591-022-01750-1
Paschoalotto MAC, Lazzari EA, Castro MC, Rocha R, Massuda A. The health systems resilience: notes for a research agenda for the SUS. Saúde em Debate. 2022 Dec;46(spe8):156–70. DOI: https://doi.org/10.1590/0103-11042022e812i
Massuda A, Malik AM, Vecina Neto G, Tasca R, Ferreira Junior WC. A resiliência do Sistema Único de Saúde frente à COVID-19. Cadernos EBAPEBR. 2021 Nov;19(spe):735–44. DOI: https://doi.org/10.1590/1679-395120200185
Brasil. Constituição da República Federativa do Brasil de 1988. Brasília: Senado Federal; Oct 5, 1988.
da Silva GDM, de Souza AA, de Castro MSM, de Miranda WD, Jardim LL, de Sousa RP. Influence of socioeconomic inequality on the distribution of COVID-19 hospitalizations and deaths in Brazilian municipalities, 2020: an ecological study. Epidemiologia e Serviços de Saúde. 2023;32(1). DOI: https://doi.org/10.1590/s2237-96222023000100021
Sanhueza-Sanzana C, Aguiar IWO, Almeida RLF, Kendall C, Mendes A, Kerr LRFS. Social inequalities associated with COVID-19 case fatality rate in Fortaleza, Ceará state, Brazil, 2020. Epidemiologia e Serviços de Saúde. 2021;30(3). DOI: https://doi.org/10.1590/s1679-49742021000300022
da Costa Miranda AL, da Paixão ART, Pedroso AO, do Espírito Santo Lima L, Parente AT, Botelho EP, et al. Demographic, social, and clinical aspects associated with access to COVID-19 health care in Pará province, Brazilian Amazon. Sci Rep. 2024 Dec 1;14(1). DOI: https://doi.org/10.1038/s41598-024-59461-1
Boitrago GM, Mônica RB, Silva DM, Cerroni M de P, Cortez-Escalante JJ, Almiron M, et al. Restructuring of emergency services to COVID-19 in Brazil: a space-time analysis from February to August 2020. Epidemiologia e Servicos de Saude. 2021;30(4). DOI: https://doi.org/10.1590/s1679-49742021000400004
de Araújo AYCC, de Almeida ERB, Lima LKES, de Sandes-Freitas TV, Pinto AGA. Fall in organ donations and transplants in Ceará in the COVID-19 pandemic: a descriptive study, April-June 2020. Epidemiologia e Serviços de Saúde. 2021;30(1). DOI: https://doi.org/10.1590/s1679-49742021000100016
Ribeiro Junior MAF, Costa CTK, Néder PR, Aveiro I de A, Elias YGB, Augusto S de S. Impact of covid-19 on the number of transplants performed in brazil during the pandemic. Current situation. Rev Col Bras Cir. 2021;48. DOI: https://doi.org/10.1590/0100-6991e-20213042
Ribeiro CM, De Miranda Correa F, Migowski A. Short-term effects of the COVID-19 pandemic on cancer screening, diagnosis and treatment procedures in Brazil: A descriptive study, 2019-2020. Epidemiologia e Serviços de Saúde. 2022;31(1). DOI: https://doi.org/10.1590/s1679-49742022000100010
Downey E, Fokeladeh S, Catton H. What the COVID-19 pandemic has exposed: the findings of five global health workforce professions [Internet]. 2023 [cited 2024 Nov 18]. Available from: https://iris.who.int/bitstream/handle/10665/366632/9789240070189-eng.pdf?sequence=1
Poon YSR, Lin YP, Griffiths P, Yong KK, Seah B, Liaw SY. A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions. Vol. 20, Human Resources for Health. BioMed Central Ltd; 2022. DOI: https://doi.org/10.1186/s12960-022-00764-7
World Physiotherapy. Impact of the COVID-19 pandemic on physiotherapy services globally. 2021.
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 Dec 1;12(1). DOI: https://doi.org/10.1038/s41598-022-13746-5
Fejfar D, Andom AT, Msuya M, Jeune MA, Lambert W, Varney PF, et al. The impact of COVID-19 and national pandemic responses on health service utilisation in seven low- and middle-income countries. Glob Health Action. 2023;16(1). DOI: https://doi.org/10.1080/16549716.2023.2178604
Pond K, Samuels K, Meinhardt G, Jacobs C. Examining Health Disparities in Orthopedic Care During COVID-19. American Surgeon. 2023 Apr 1;89(4):583–8. DOI: https://doi.org/10.1177/00031348231153551
Arnetz BB, Goetz C, vanSchagen J, Baer W, Smith S, Arnetz JE. Patient-reported factors associated with avoidance of in-person care during the COVID-19 pandemic: Results from a national survey. PLoS One. 2022 Aug 1;17(8 August). DOI: https://doi.org/10.1371/journal.pone.0272609
Agency for Healthcare Research and Quality. 2023 National Healthcare Quality and Disparities Report [Internet]. 2023 Dec. Available from: https://www.ahrq.gov/research/findings/nhqrdr/index.html
Suda BTR, dos Santos Mota PH, Bousquat A. Specialized Rehabilitation Centers (CER) in the SUS and the impact of the covid-19 pandemic. Rev Saude Publica. 2023;57. DOI: https://doi.org/10.11606/s1518-8787.2023057004807
Conselho Federal de Fisioterapia e Terapia Ocupacional. Resolução No 516, de 20 de março de 2020 – Teleconsulta, Telemonitoramento e Teleconsultoria. Brasília: COFFITO; Mar 20, 2020.
Freire MP, Silva LG, Meira ALP, Louvison MCP. Telemedicine in healthcare access during the covid-19 pandemic: a scoping review. Vol. 57, Revista de Saúde Pública. Universidade de São Paulo. Museu de Zoologia; 2023. DOI: https://doi.org/10.11606/s1518-8787.2023057004748
Hatef E, Wilson RF, Zhang A, Hannum SM, Kharrazi H, Davis SA, et al. Effectiveness of telehealth versus in-person care during the COVID-19 pandemic: a systematic review. Vol. 7, npj Digital Medicine. Nature Research; 2024. DOI: https://doi.org/10.1038/s41746-024-01152-2
