Características dos atendimentos do serviço de atendimento regional móvel de urgência (SAMU192/CISDESTE): uma abordagem com ênfase na atenção primária e na lógica das redes de atenção à saúde

Abstract

SAMU 192 (Mobile Emergency Care Service) is a mobile pre-hospital emergency service designed to provide early intervention for victims following an incident affecting their health, whether of a clinical, traumatic, psychiatric, gynecological/obstetric, or pediatric nature. Its primary goal is to ensure skilled and high-quality care by providing the most appropriate and timely access to the healthcare system, aiming to minimize complications and safeguard the patient’s life, while reducing hospitalization time and the risk of death. The Regional Mobile Emergency Care Service – CISDESTE, a tripartite public consortium, provides urgent and emergency care in 147 cities in the state of Minas Gerais, with its headquarters in Juiz de Fora/MG. This study aims to characterize the demands attended by SAMU 192/CISDESTE in the municipality of Juiz de Fora/MG, seeking to assess the effectiveness of the city's Emergency and Urgent Care Network, especially in relation to Primary Health Care, during the period from October 2022 to September 2023. Secondary data were collected from the Information System of the SAMU 192/CISDESTE Emergency Regulation Center. Statistical analyses were performed using SPSS software, version 21. Absolute and relative frequencies were calculated for categorical variables. Pearson’s Chi-Square test and Fisher’s exact test were used to assess associations between variables, while the adjusted standardized residual post-hoc test identified the specific cells that contributed most to the test results. A 95% confidence interval was adopted. Among the 76,616 ambulance-assisted cases in the SAMU 192/CISDESTE coverage area during the study period, 23,953 (31.26%) were attended in Juiz de Fora/MG. Of the 22,510 analyzed cases, 53.6% of the patients were male, with a significant association with trauma-related incidents. The ≥60 age group was the most prevalent among all cases (44.1%). Clinical cases accounted for the majority (64.8%), with a higher occurrence among women and elderly individuals. The most frequent reason for care was falls from their own height (8.8%). The neighborhoods with the highest emergency service demands, particularly Centro (13.1%), have coverage from primary healthcare units (UBS), predominantly served by Family Health Strategy teams. However, 58.6% of emergency calls occurred outside UBS operating hours. Regarding the risk classification used to establish priorities, 51.02% of cases were classified as low-urgency or non-urgent demands. The most common outcome was referral to higher-complexity healthcare facilities (65.2%). Together, these findings highlight weaknesses in the healthcare network, as emergency services are often used for cases that could be resolved at the primary and secondary care levels. This evidence may help municipal health managers implement strategies to enhance comprehensive patient care, promote the appropriate use of healthcare resources, and ensure equitable access to urgent and emergency services.