Os programas de saúde digital e o acesso ao Sistema Único de Saúde pela população idosa da cidade de São Paulo durante a pandemia de COVID-19

Abstract

INTRODUCTION: As the World Health Organization declared COVID-19 a pandemic in March 2020, the search for tools that could preserve population linkages to the health system while also avoiding unnecessary displacement became imperative, highlighting the need to employ telemedicine. Older adults have been one of the most vulnerable population groups during the COVID-19 pandemic; although they represent only approximately 14.7% of the Brazilian population, between March 2020 and April 2022 they accounted for 71% of COVID-19 deaths throughout the country. OBJECTIVE: To study technology-facilitated access to the health system by the elderly population of the city of São Paulo, Brazil, during the COVID-19 pandemic, and obtain indicators of public health system utilization by the elderly population in pre-pandemic and pandemic years. METHODS: The rates and proportions of telehealth visits, stratified per user district of residence within the city of São Paulo, were calculated for the period March 2020 through December 2021. The ratio of Unified Health System primary-care visits in the population aged 60 years and older to the total population within the same age group, an established indicator, was compared with the ratio of Unified Health System primary-care telehealth visits in the population aged 60 years and older to the total population within the same age group. RESULTS: Between March 2020 and December 2021, 2,934,506 telehealth visits were conducted. Older adults accounted for approximately 20% of these, with 60-to-69-year-olds being the age group that most used these technologies. Telehealth visit rates were particularly concentrated among elderly residents of the South and Southeast regions of São Paulo. Proportionally, the highest concentration of procedures in the older population occurred in the Center and West regions of the city. The ratio of telehealth visits was 8.11 in 2020 and 13.69 in 2021, with primary care being the service most often used in both 2020 and 2021. CONCLUSION: This study identified adherence to technological alternatives meant to support care of the elderly population and maintain this population’s linkage to the health system, with a view to ensuring continuity of care of their health conditions while enjoying the protection provided by social distancing during the pandemic. In addition, a novel health indicator is proposed: the ratio of Unified Health System primary-care telehealth visits in the population aged 60 years and older to the total population within the same age group.