New paths for specialized care in the Municipality of Rio de Janeiro, Brazil: results from the Super Centro Carioca de Saúde.

The Outpatient Regulation System in the Municipality of Rio de Janeiro (MRJ) faced a significant increase in demand for doctor´s appointments, exams, and surgeries between 2020 and 2024. The creation of the Carioca Super Health Center (Super Centro Carioca de Saúde - SCCS) in 2023 aimed to improve access to specialized procedures and reduce waiting times. A descriptive cross-sectional study was conducted based on data available at the Transparency Portal to evaluate the frequency of requests, available slots, authorizations, and waiting times between 2020 and 2024. There was a 3.7-fold increase in requests and a 4-fold increase in authorizations between 2020 and 2024. The SCCS contributed 19% of the total available slots in 2023, especially for imaging and ophthalmology procedures. The mean waiting list decreased by 4% over the period, with a 44% reduction in exam waiting lists and a 39% reduction in average waiting time. However, waiting lists for doctors' appointments increased by 38%. The expansion of service capacity and the establishment of specialized units like the SCCS were effective in reducing waiting times for exams and surgeries. Nevertheless, the continuous increase in demand, especially for doctor´s appointments, suggests the need for ongoing planning and effective policies for waiting list management and service prioritization.