[Simulation model for estimating the cancer care infrastructure required by the public health system].
OBJECTIVE
To develop a simulation model using public data to estimate the cancer care infrastructure required by the public health system in the state of São Paulo, Brazil.


METHODS
Public data from the Unified Health System database regarding cancer surgery, chemotherapy, and radiation therapy, from January 2002-January 2004, were used to estimate the number of cancer cases in the state. The percentages recorded for each therapy in the Hospital Cancer Registry of Brazil were combined with the data collected from the database to estimate the need for services. Mixture models were used to identify subgroups of cancer cases with regard to the length of time that chemotherapy and radiation therapy were required. A simulation model was used to estimate the infrastructure required taking these parameters into account.


RESULTS
The model indicated the need for surgery in 52.5% of the cases, radiation therapy in 42.7%, and chemotherapy in 48.5%. The mixture models identified two subgroups for radiation therapy and four subgroups for chemotherapy with regard to mean usage time for each. These parameters allowed the following estimated infrastructure needs to be made: 147 operating rooms, 2 653 operating beds, 297 chemotherapy chairs, and 102 radiation therapy devices. These estimates suggest the need for a 1.2-fold increase in the number of chemotherapy services and a 2.4-fold increase in the number of radiation therapy services when compared with the parameters currently used by the public health system.


CONCLUSIONS
A simulation model, such as the one used in the present study, permits better distribution of health care resources because it is based on specific, local needs.
Gomes Junior
Saint Clair Santos
SC
Fundação Oswaldo Cruz, Instituto Fernandes Figueira, Unidade de Pesquisa Clínica, Avenida Rui Barbosa 716, Rio de Janeiro, RJ, Brazil. scgomes@iff.fiocruz.br
Almeida
Rosimary Terezinha
RT
D001938:Brazil; D003198:Computer Simulation; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards*; D015233:Models, Statistical; D009369:Neoplasms / Q000628:therapy*; D011634:Public Health