Medical care situation in the State of Ceara, Brazil

Abstract

The situation of medical care in the State of Ceara (Brazil) was estimated through the analysis of the offering of the official services on public health, hospital and "para-hospital" care and by the existent human resources as well. This region has 141 towns and aproximately 4,000.000 inhabitants. The official services on Public Health are concerned to State public expense in 59.6% of the sanitary units; Federal government gives its participation in 26.9% and the city council helps in 13.5%. The quantitative standard observed was considered as been satisfactory, since as a rule there is one sanitary unit per each 23,002 inhabitants. This average is very near to the required one unit per each 50,000 inhabitants. The qualitative appreciation, considered indirectly through the actual laboratory and human resources, seemed to be inefficient since only 16.7% of the health units have laboratory and 12.3% have no physicians; 21.7 (39) of the health center are closed because of the lack of this kind of professional related above. Paralel to this situation one can detect the existance of equipments completely out of date and the nearly absolute defficiency in the section of drug supply. From the 141 towns which compose the Region of Ceara, 31 (22%) have no health unit and in 25 (17.7%) we don't find any health resource. In the first presented case the population of medical care theoretically found out is of 378,449 inhabitants and in the second case it is of 232,900 inhabitants. From the 103 actual hospitals in this present Region 77.7% is on the responsability of the private section and 25% is concentrated in the capital of the Region. The quantitative standard of 1.84 beds/1000 inhabitants (7047 beds) is extremely low when compared with the Brazilian average of 3.6 beds. The theoretically recomended average is 4.5 (beds). From the total number of beds 1.10/1000 are considered general and 0.74/1000 are specialized (tuberculosis, leprosy and psychiatry). The qualitative stantard of the hospital attendance is implicated since only 22.3% of the foundation have laboratory; 31.1% have X Ray apparatus and 11.6% present electro-cardiography. The most proeminent shortage of these resources occur in the countryside of this Region. More than 50.0% of the hospitals have no professional on health section, such us nursery, nutritionist, social work and technicians. From the 141 towns, 62.7% (89) have no hospitals, consequently about 1,300.000 inhabitants are theoretically in need of hospital care. Related to the 86 para-hospital units, through the lack of data is bigger, the situation is rather similar to the hospital care. There are 1207 physicians in the Region who offer a patterns of 0.3 physicians/1000 inhabitants when the recomended patern theorically is an average 1/1000. In spite of being a rather insignificant rate there is an unfair distribuition of physicians for 77.7% of these workers are concentrated in the capital of the Region (1.1/1000 inhabitants). Only 45.4% of the cities have resident physician, related to dentistry field one can observe a low quantitative pattern of 0,28 workers per 2.000 inhabitants when the generally acceptable amount is of 1/2000 inhabitants. Concerning with the para-medical workers there is a predominance of medical attendants in the Official Services of Public Heath and as it has already been mencioned above more than 50.0% have no qualified workers in the hospitals.