Issue/problem
Covid-19 pandemic requires rapid responses. The reconfiguration of the psychosocial care network was needed to ensure access to all patients during this period.
Description of the problem
Psychosocial Care Centers (PCC) are strategic equipment for strengthening the mental health policy in Brazil. These services work with a multi and interdisciplinary team, aiming to assist crisis and rehabilitation processes of people with severe and persistent mental disorders or those with impairments due to the use of psychoactive substances. This work shares the experience of two PCC over the COVID-19 pandemic in São Paulo, Brazil. In April 2020, in front of the increasing Covid-19 cases and hospitalization, lack of hospital beds for mental health care, suspension of PCC group activities, and restriction of face-to-face assistance, it was necessary to adjust the PCC work process and physical structure.
Results
Telemedicine was implemented to assure assistance and monitoring. An internal flow was implemented to identify and assess patients seeking the service with respiratory symptoms and proceed with case notification if confirmed. A station for respiratory symptoms screening was settled outside the PCC, an isolation room to symptomatic respiratory patients was defined to medical assessment, and referral criteria to the emergency care established. To reinforce beds for hospitals in the region, inpatient beds were created in the PCC to attend hospitalization of acute crisis cases. Further, professionals from Primary Health Care were relocated and trained to support PCC assistance.
Lessons
This experience reaffirms the role of PCC as an articulator of the psychosocial network. Reorganization of PCC work process enabled the continuity of mental health outpatient care as well as rearguard from inpatient beds.
Key messages
The COVID-19 pandemic reinforce the necessity of integrated healthcare networks to provide care access and continuity of care. This experience reaffirms the role of PCC as an articulator of the psychosocial network.
Objetivo: Verificar o perfil epidemiológico das gestantes e os fatores associados com o encaminhamento de gestantes para um serviço especializado. Método: Estudo transversal retrospectivo, realizado nos prontuários de gestantes classificadas em alto risco, período de janeiro a dezembro de 2019. Realizou-se análise descritiva, bivariada e multivariada. Resultados: Dos 405 prontuários, a média de idade foi 29 anos, 19% eram hipertensas crônicas, 14,2% desenvolveram diabetes gestacional. A diferença média entre a data da primeira consulta e a data do encaminhamento pela atenção primária foi de 4 semanas. A regressão logística mostrou que: gestantes de outros municípios, com baixa renda econômica e diferença no tempo de encaminhamento possuem interferência no início do pré-natal. Conclusão: As análises realizadas poderão contribuir para a elaboração de políticas intersetoriais em busca da promoção da saúde de gestantes.
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