Avaliação dos serviços de saúde e qualidade de vida de diabéticos durante a pandemia da Covid-19

Abstract

Considering the growing number of diabetics in Brazil and worldwide and recognizing that individuals with this comorbidity are more likely to have more severe symptoms and complications from COVID-19, we aimed to assess the pattern of use of health services (USS) according to social determinants and quality of life (QL) of type 2 diabetics assisted by the Family Health Strategy (ESF) of the municipality of Paraíba during the COVID-19 pandemic. In this cross-sectional population-based study with a quantitative approach, data collection was performed by telephone when two validated questionnaires were applied. Analyzes conducted using SPSS Statistics 25.0 software included descriptive, bivariate and multivariate statistics through Decision Tree modeling using the Chi‑squared Automatic Interaction Detector (CHAID) algorithm and Cluster Analysis. Most of the participants used the public health service without regularity (51.9%), they had a low impact of the disease on their QOL (63.4%). The variables: monthly family income (p = 0.003), employment status (p = 0.026) and number of systemic complications (p = 0.043) demonstrated to play a relevant role in understanding the use of health services among DM patients, finding an association between use of the public health service without regularity and people with lower income, occurrence of complications from systemic diseases and unemployment situation. Thus, disparities related to social determinants, health behaviors and the impact of diabetes on the QoL of users can explain the USS, in addition to exceptional situations, such as the crisis generated by the pandemic, aggravating or significantly modifying the situation. Therefore, it is essential to develop policy measures aimed at this most vulnerable group, directing the discussion between professionals and managers to improve service to users, whether within or outside the pandemic context.