Territorial Vulnerabilities and Healthcare Capacity During the COVID-19 Pandemic: A Spatiotemporal Study of Hospitalizations and Mortality in a Large Metropolitan Area in Brazil.

OBJECTIVE

This study aimed to identify priority areas, social vulnerability, and healthcare capacity and networks while considering hospitalization and mortality rates due to Severe Acute Respiratory Syndrome (SARS) caused by COVID-19 during the public health emergency period.

MATERIALS AND

METHODS

A spatiotemporal analysis was performed to assess hospitalization, mortality, and case fatality rates among hospitalized patients due to severe COVID-19 across the municipalities of the Metropolitan Region of Belo Horizonte (MRBH), Brazil, between 2020 and 2022. The findings were contextualized by considering the social vulnerability of the population as well as the healthcare infrastructure and organizational characteristics of municipalities and health regions.

RESULTS

Municipalities located in the central area of the MRBH showed higher hospitalization rates, corresponding to areas with a greater concentration of healthcare infrastructure. However, mortality and case fatality rates among hospitalized patients were higher in municipalities with more limited healthcare infrastructure and greater social vulnerability.

CONCLUSION

The spatiotemporal disparities in hospitalization and mortality risks suggest health inequities that seem to be influenced by social determinants and healthcare system vulnerabilities. These findings emphasize the imperative for public health emergency responses to prioritize the strengthening of health system organization and the establishment of effective care pathways to enhance access and service delivery, particularly in municipalities exhibiting higher levels of social vulnerability.