The Treatment Profile of a "Upa" and the Impact on Brazilian Public Healthcare

In the Brazilian “Sistema Único de Saúde”, primary care is the gateway in order to reduce hospital admissions. However, crises in this system led to the opening of large emergency hospital units, stimulating demand for tertiary hospitals and creating faster access. To take care of this situation, the “Unidades de Pronto Atendimento” (UPA) would be responsible for receiving cases of small and medium urgency, playing an important role in secondary care emergency. The aim was to describe the reason for seeking care at a UPA, located in Rio de Janeiro, Brazil. The survey targeted patients attending the UPA and, therefore, we analyzed reports of attendance in September 2011. Data were stored and analyzed using Epi Info version 3.5.1. Of the 182 records, 73.3% were from General Medicine, 15.6% Pediatrics and 10.0% of Dentistry.The average age was 33.69 years (SD ± 20.44) and 50.5% were male. With relation to residence, 54.2% were residents of the program area (PA) 3.3 (of these, 15.3% were from Madureira district), the same area of the UPA, and 25.4% of PA 4.0 (with 14.2 % Praça Seca). In terms of outcome, 84.0% of patients were discharged, 9.4% sent to basic care units and 0.6% were transferred to hospitalization. As to the diagnosis of care, it was observed that 18.1% were infections of ear, nose or throat; 10.4% myalgia or arthralgia; 9.9% skin and subcutaneous tissue; 9.3% with dental problems; and 7.1% gastroenteritis and other infectious complications. The results show that most cases could have been avoided or minimized through the adoption of strategies for primary care and primary prevention, which would improve the quality of care, optimization of disease control and potential resource savings by avoiding saturation of meeting the UPAs.