Origin-destination flows in chemotherapy for breast cancer in Brazil: implications for pharmaceutical services

• Main Authors: Mário Jorge Sobreira da Silva, Enirtes Caetano Prates Melo, Claudia Garcia Serpa Osorio-de-Castro
• Format: Article
• Language: English
• Published: Associação Brasileira de Pós-Graduação em Saúde Coletiva
• Series: Ciência & Saúde Coletiva
• Subjects: Assistência farmacêutica; Assistência à saúde; Câncer de mama; Análise espacial; Acesso aos serviços de saúde
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232019000301153&lng=en&tlng=en

Abstract This study maps and analyzes patient flows for breast cancer chemotherapy in order to identify the potential implications for organization of pharmaceutical services in the cancer care network. An ecological study design sought to correlate the place of residence with place of care for breast cancer patients. All chemotherapy procedures financed by Brazil’s Unified Health System (SUS) and performed from January to December 2013 were included. Flows were mapped using TerraView® software. A total of 1 347 803 outpatient chemotherapy procedures were delivered by 243 cancer care units located in 156 municipalities. Seventeen cities concentrated approximately 50.0 % of the procedures. A total of 8 538 origin-destination flows were generated and 49.2% of procedures were performed in services located outside the municipality in which the patient resided. Context challenges, related to inequality of access to chemotherapy and hindrances in planning and management of pharmaceutical services, were discussed.