Brazilian Policies and Programs in Urgent and Emergency Care Services in the Context of Cardiovascular Diseases: A Scoping Review

Abstract

Introduction: Cardiovascular diseases (CVD) are a major cause of mortality in Brazil, requiring the improvement of healthcare mechanisms that can promote rapid and effective care for patients.Objectives: To identify and characterize Brazilian policies and programs (PP) regarding urgency and emergency care in the context of CVD.Method: The scoping review followed recommendations from the Joanna Briggs Institute (JBI). The search for studies was conducted across seven databases. The screening and eligibility steps were performed by reviewers independently, with conflicts resolved by consensus or consultation with a third reviewer. The data extraction was done in a spreadsheet and the information was analyzed and grouped by content similarity.Results: Through the analysis of 14 studies, a systematic and contextualized understanding was gained regarding 10 PPs implemented in the urgency and emergency network (RUE) for individuals with CVDs. SAMU emerged as the most extensively studied PP, predominantly in the state of Minas Gerais. The diseases most commonly addressed in these studies included acute myocardial infarction (featured in 80% of publications), stroke, acute coronary syndrome, heart failure, and atrial fibrillation. These PP have demonstrated significant improvements in clinical outcomes, particularly in reducing morbidity and mortality rates. The studies also revealed important insights into barriers and drivers related to infrastructure, health education, and system management and coordination. Conclusion:The evidence gathered provides significant contributions to guide future policy development and improve decision-making in clinical management for cardiologists.