Atenção oncológica no sistema único de saúde em Mato Grosso do Sul: fluxos assistenciais, deslocamentos e desigualdades regionais

Abstract

This study analyzes the effects of the territorial distribution of oncology care services in Mato Grosso do Sul on the care pathway and displacement of patients undergoing treatment within the Brazilian Unified Health System (SUS), with an emphasis on the Southern Cone macroregion. Despite the relevance of the topic, there is a scarcity of in-depth analysis in health regions that integrates installed capacity, care flows, and patient displacement. This is a quantitative, descriptive, comparative, and spatial study, based on secondary data from the SIH, SIA, CNES, and IBGE systems from 2019 to 2024. Frequencies, rates, and locations of care were analyzed, including estimates of patient displacement. The results show a concentration of oncology services in the capital (Campo Grande), a lack of care in the Southern Cone region, and significant patient flows to other states (São Paulo and Paraná), which can exceed 900 km for continuous treatments (chemotherapy and radiotherapy). The scenario in the Southern Cone region represents a significant barrier that influences access and is reflected in clinical outcomes. There has been a 38% increase in cancer-related deaths in the state; among residents of the Southern Cone region, this increase is more pronounced, reaching 201%. There is a moderate correlation between the death rate and the distance traveled to treatment destinations. With an adjusted coefficient of determination (R²) of 26%, the study did not establish a definitive causal relationship between distances traveled and death rates, but it contributes by presenting relevant empirical evidence that can support decisions regarding network expansion, resource allocation, and reorganization of the oncology care pathway. The study suggests the need for short-term actions in the areas of prevention, early diagnosis, and timely treatment.