Serviços na atenção e proteção básica à pessoa idosa: destaque nas regiões brasileiras e mecanismos de interface intersetorial

Abstract

The rapid process of population aging in Brazil has increased the necessity of strengthening the care networks directed to the elderly population. In this context, the present study objectified a comparative analysis of the territorial distribution of the services of Primary Health Care (APS), of Basic Social Protection (PSB) and of Intersectoral Services destined to the elderly person in the five Brazilian regions, considering the years 2022 and 2024. The dissertation was elaborated through a qualitative bibliographic review about the challenges of APS in the care to the elderly person and of a descriptive quantitative study based on data originating from the DGeroBrasil project. Furthermore, complementary information from the National Registry of Health Establishments (CNES), SUAS Census and other official public databases were utilized. The bibliographic review identified challenges related to the essential attributes of APS, highlighting the high turnover of professionals, weaknesses in the articulation of the service network and difficulties of access to the assistance. As demonstrated in the analysis of the services, in the year 2022, 31,514 services of APS, 15,994 of PSB and 4,281 Intersectoral Services were identified. The proportional analysis demonstrated the existence of regional inequalities, with greater population coverage of services in the South region and greater proportions of services per municipality in the North region. Between 2022 and 2024, an increase of 5,749 units was observed in APS, totaling 37,263 services, while PSB registered an increase of 491 units, reaching 16,485 services. In counterpoint, the reduction of 875 Health Posts and of 203 teams of the Family Health Strategy was verified. In the Intersectoral Services, an increase of the registries of Municipal Councils of the Elderly Person was observed, from 821 to 4,027. However, the unavailability of standardized data for part of the intersectoral devices in 2024 limited the temporal comparison and the complete analysis of this component. It is concluded that, despite the amplification of the offer of services directed to the elderly population between 2022 and 2024, important territorial inequalities persist in the distribution of the resources of health, social assistance and intersectoral protection. The results of the study reinforce the importance of planning, of monitoring and of the strengthening of the care networks, as well as of the qualification of information systems, aiming to promote greater equity in the care to the Brazilian elderly population.