OVERCROWDING IN EMERGENCY SERVICES DURING SEASONAL PERIODS: STRATEGIES FOR ORGANIZING CARE IN URGENT CARE UNITS – LITERATURE REVIEW

Abstract

Overcrowding in emergency services is a global problem that compromises the quality of care and patient safety, characterized by an imbalance between demand and the operational capacity of the units. In the Brazilian context, Emergency Care Units (UPAs) play a strategic role in the Emergency Care Network, but continue to face high demand for care. Factors such as insufficient hospital beds, fragility of primary care, and inappropriate use for low-complexity cases contribute to the overload of services, aggravated during seasonal periods marked by an increase in respiratory diseases, epidemics, and traumatic events. This is a narrative literature review, with a qualitative approach, carried out in the LILACS, SciELO, and MEDLINE databases, considering publications between 2009 and 2023 in Portuguese, English, and Spanish. Studies addressing overcrowding in emergency services were included and analyzed regarding the main associated factors and care organization strategies. Selection was carried out through reading titles, abstracts, and full texts, with subsequent extraction and descriptive analysis of the data. The results show that overcrowding has a multifactorial character, highlighting the prolonged stay of patients, failures in bed regulation, and seasonal increases in demand. This scenario negatively impacts waiting times, quality of care, and working conditions for healthcare teams. Coping strategies include risk classification, reorganization of the care flow (fast track), adoption of Lean Healthcare, and integration between levels of care. It is concluded that addressing overcrowding requires a systemic approach, planning based on epidemiological data, and strengthening of the healthcare network, especially during periods of higher seasonal demand.