Abstract
Introduction: Monitoring the use of highly complex equipment according to the principles of the SUS is essential for the management of decision-making to meet the demands of the population. This study aimed to show the use of Computed Tomography (CT) considering its geographic location, quantity, supplier companies, types of procedures available and those approved at the regional and Federation Unit level during the pre, during and post-COVID-19 pandemic period. Methods: This is a descriptive and retrospective study using public databases. The Procedure, Medication and OPM Table Management System (SIGTAP), the National Registry of Health Establishments (CNES) and the Outpatient Information System (SIA) were consulted. The procedures that can be reimbursed, the number of equipment in use and the number of procedures approved in the SUS during the pre-pandemic (2019), during-pandemic (2020-2021) and post-pandemic (2022) periods were verified. The population in the period was obtained from the database of the Brazilian Institute of Geography and Statistics (IBGE). Results: The procedures approved for reimbursement in the SUS are grouped into three groups: 01-Tomography of the head, neck and spine; 02-Tomography of the chest and upper limbs; and 03-Tomography of the abdomen, pelvis and lower limbs. Throughout the studied period, the Southeast region had the highest number of CT equipment, followed by the Northeast, South, Central-West and North regions. In the pre-, during- and post-pandemic periods, the national average of CTs per 100 thousand inhabitants was, respectively, 2.37; 2.72 and 2.92. In the pre-pandemic period, the Central-West region stood out with an average of 3.37 CT scans per 100,000 inhabitants, followed by the South (2.95), Southeast (2.69), Northeast (1.57), and North (1.52). In the pre- and post-pandemic periods, these values increased uniformly in all regions. The Southeast region stands out with the highest number of procedures approved throughout the period, followed by the South, Northeast, Central-West, and North regions. However, the South region approved more procedures per million inhabitants, followed by the Southeast, Central-West, North, and Northeast regions. The number of chest CT scans per million inhabitants exceeded that of the skull during the pandemic. Discussion and conclusions: All regions have at least one CT scan per 100,000 inhabitants. However, this distribution is not uniform and, despite the general increase due to the COVID-19 pandemic, the difference between regions remained. Although the Central-West region has the highest density of equipment, it is the third in approved procedures per million inhabitants. The South region has the second largest technology park per 100 thousand inhabitants, but leads the number of approved procedures per million inhabitants. This may be due to several factors, as discussed by Rocha et. al (2019) and Santos et. al (2014). The inequalities presented suggest greater difficulty in the population's access to this type of technology, especially in some regions. This indicates the need for regional assessments to increase efficiency of use and improve its management and planning.
