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TD 1151 - Um Estudo Multinível Sobre as Filas Para Internações Relacionadas com a Gravidez, o Parto e o Puerpério no SUS

Alexandre Marinho e Simone de Souza Cardoso / Rio de Janeiro, janeiro de 2006

O presente trabalho avalia os tempos de espera no Sistema Único de Saúde (SUS), para as internações relacionadas com o capítulo XV (gravidez, parto e puerpério) da CID-10 para os anos de 1999 e 2002. Primeiramente, estimamos os tempos de espera para atendimento com o auxílio de modelos da teoria das filas. Em seguida, identificamos os fatores de risco materno, os de risco social e os fatores assistenciais determinantes desses tempos de espera, em modelos econométricos do tipo multinível.

This work studies the waiting times for the chapter XV of the ICD-10 (pregnancy, childbirth and puerperal care) in the years of 1999 and 2002 within the Brazilian National Health System (SUS). The average waiting times were estimated by queueing theory models. We used multilevel regression models to explain the waiting time variations across municipalities and across states. The average waiting time that patients wait for service were found to be very long and highly elastic with respect to arrival and service rates in the system. These waiting times also presents great variability across municipalities and across states. We estimate that the frequency of low birth weight; the caesarian section rates; the total fertility rate; the Human Development Index (HDI); and the proportion of non-resident cases treated are positively associated with waiting times. On the contrary, the utilization of prenatal care; the rates of nurses with higher level of education; and the per capita total expenditure on health are negatively associated with waiting times.

 

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