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SUS perde 43 mil leitos de internação desde 2009

O Globo relata que o Sistema Único de Saúde (SUS) teve uma redução de 43 mil leitos de internação desde 2009, numa queda de 12,7%, em números relativos aos meses de junho dos últimos dez anos. Só do ano passado para este ano, a diminuição foi de quatro mil leitos. Os dados são do Ministério da Saúde e foram obtidos pelo jornal.

Atualmente, o SUS conta com 298 mil leitos de internação, contra 341 mil em 2009. 0 estado que mais perdeu leitos foi o Rio de Janeiro, com uma redução de 35,5%, seguido por Sergipe e Goiás, com quedas de 26,3% e 19,4%, respectivamente.

Os leitos complementares, que incluem os de UTI e de unidade intermediária, tiveram um aumento de 22,8 mil para 30,9 mil no mesmo período. De acordo com o Ministério de Saúde, isso reflete um investimento mais forte nos processos de maior complexidade.

Em resposta ao GLOBO, o ministério afirmou que a redução segue uma tendência mundial de substituição dos leitos de internação pelo atendimento ambulatorial e domiciliar.

“A redução segue tendência mundial de desospitalização – com os avanços tecnológicos, tratamentos que exigiam internação passaram a ser feitos no âmbito ambulatorial e domiciliar, com ampliação e reforço da atenção primária e de ações de prevenção e promoção”, afirmou, em nota.

Contudo, números do orçamento do ministério não refletem aumento do investimento em atenção básica. Nessa área, cujo avanço poderia explicar a redução de leitos, os dados orçamentários de 2014 até 2018 também mostram uma diminuição dos gastos. As despesas caíram de R$ 22,6 bilhões em 2014 para R$ 20,8 bilhões no ano passado. Corrigida pela inflação, a queda foi de 8%.

No caso do orçamento executado para a assistência hospitalar e ambulatorial, houve aumento nominal desde 2014, mas uma queda real quando corrigida pelo IPCA (índice Nacional de Preços ao Consumidor). Em 2014, o orçamento era de R$ 54,6 bilhões e em 2018 apresentou redução de R$ 3 bi, chegando a R$ 51,5 bi em valores corrigidos.

Segundo o professor da Universidade do Estado do Rio de Janeiro (Uerj) e doutor em saúde pública Mario Dal Poz, a diminuição pode ser explicada por três eixos.

– Um é decorrente da melhoria do conhecimento, dos protocolos; um segundo, ruim, que é decorrente da crise de financiamento que a gente tem, principalmente no Sistema Único de Saúde; e o terceiro, que é o processo de gestão, que vem reduzindo progressivamente o tamanho dos hospitais – disse o professor.

Para o coordenador da Comissão Pró-SUS do Conselho Federal de Medicina (CFM), Donizetti Giamberardino, existem “vários fatores” no processo de diminuição dos leitos de urgência, mas o principal seria a redução no repasse de verbas.

– A medida em que você tem um menor financiamento do sistema SUS, você tem um fechamento dos leitos – explica.

Quem usa o sistema vivência a redução. A moradora de São Paulo Edmer da Costa, de 63 anos, acredita que o número de leitos é insuficiente e classifica a situação atual da saúde como “precária”. Para ela, nos últimos dez anos, houve uma diminuição da qualidade do serviço público. Edmer foi neste mês ao Hospital de Base, em Brasília, cuidar do irmão que está com câncer de pulmão.

A aposentada diz ainda que nos últimos meses frequentou hospitais em São Paulo para acompanhar o marido, que sofria de insuficiência respiratória e acabou morrendo, em junho, e que os atendimentos foram “péssimos”.

– O povo fica nos corredores. Meu marido ficou uns cinco, seis dias no corredor – relata Edmer.

De acordo com ela, também não havia cadeira para que os acompanhantes pudessem descansar.

– Quando não achava onde sentar, a gente ficava em pé mesmo – conta.

Para o presidente do Conselho Nacional de Secretarias Municipais de Saúde (Conasems), Mauro Junqueira, existe um “subfinanciamento crônico” da saúde no Brasil. Ele afirma que a situação ficou ainda mais complicada depois da Proposta de Emenda Constitucional do Teto de Gastos, aprovada pelo Congresso em 2016, que limitou os investimentos na área por 20 anos.

– Um gestor que tem juízo não abre leitos porque sabe que, se abrir, não vai poder usá-los – explica.

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