O impacto da pandemia de COVID-19 na produção ambulatorial em saúde bucal na atenção primária à saúde da área rural do município de Manaus, Amazonas

Abstract

The pandemic of COVID-19 had repercussions on the supply of oral health services around the world. Aiming to assess the impact of the pandemic of COVID-19 on outpatient production in oral health in primary care in the rural area of the municipality of Manaus, Amazonas, an ecological type study was conducted, with data collection from secondary data from the Sistema de Informação em Saúde da Atenção Básica (Sisab), referring to dental procedures in the rural health units of the city, in the period between January 2017 and December 2022. The procedures were classified into three categories, based on guidance from the American Dental Association for dental care during the pandemic, into: non-emergency procedures, emergency procedures, and case-dependent emergency procedures, and grouped according to the type of establishments - land-based, riverside, and fluvial. Outpatient production was organized according to month and year for the establishments in the rural area of the city of Manaus, filtered by the Cadastro Nacional de Estabelecimentos de Saúde. A descriptive analysis was carried out by means of the absolute monthly frequency of the procedures and the evolution in the quantitative of procedures was presented by means of time trend graphs. The comparison between the pre-pandemic and pandemic periods was performed using the Wilcoxon non-parametric test. The results demonstrated a decrease in the supply of oral health services for the groups of elective and urgent case-dependent dental procedures in the three types of establishments, land-based, riverside, and riverine, soon after the beginning of the pandemic. In the land and riverside units, this reduction was accompanied by a slow and gradual resumption in the number of procedures performed, especially from the second half of 2021, so that there is no longer a quantitative difference in outpatient production between the two periods (pre-pandemic and pandemic). Although the fluvial health units have also shown an increase in the quantity of elective and urgent case-dependent procedures, they have not yet recovered and the reduction is still persistent, with a significant difference in the quantity of these procedures between the period before and during the pandemic.