Abstract
Introduction: Modifications in the Brazilian Unified Health System (SUS) have led to a significant improvement in the national health indexes. However, some challenges still need to be faced, especially concerning SUS patients' access to high-quality laboratory support services. Objective: To evaluate the present status of laboratory services in SUS in 31 cities of Minas Gerais, Brazil, between 2008 and 2011. Material and method: This analysis was performed through data from the Information Technology Department of SUS (DATASUS) and through interviews with local public health managers with structured questionnaires. Results: Among all the studied cities, 21 had their own laboratory, 90.2% of which were in precarious conditions, not meeting the requirements established by the legislation in force, and employing inappropriate procedures and techniques, in addition to using obsolete equipment. The range of available laboratory tests was limited, what demanded the services of supporting laboratories. None of the evaluated laboratories developed any systematic activity on quality management, including control of analytical quality, maintenance of laboratory equipment, calibration and performance evaluation of critical equipment, continuing education programs, and safety and biosecurity. Conclusion: The effective role of laboratory test results in medical decision is unquestionably impaired, risking the safety of SUS patients. The present work reveals the deficiencies of public laboratory services in Minas Gerais, and proposes a new management model, which is able to associate operational quality, technological development and optimization of human and material resources with higher productivity.
Highlights
Modifications in the Brazilian Unified Health System (SUS) have led to a significant improvement in the national health indexes
The present work proposes the evaluation of SUS laboratory assistance, in outpatient clinics of cities in the state of Minas Gerais, using primary data gathered through interviews with local municipal health officers and laboratory staff, and secondary data from DATASUS database and the State Health Office of Minas Gerais
According to the Brazilian Institute of Geography and Statistics (IBGE), in 2011, the 31 cities included in the present work had a total of 3,525,650 inhabitants, representing 18% of the total population in the state, with a gross domestic product (GDP) per capita of US$1,990.20 to US$13,841.42 and an Human Development Index (HDI) of 0.693 to 0.839(17, 32)
Summary
Modifications in the Brazilian Unified Health System (SUS) have led to a significant improvement in the national health indexes. Objective: To evaluate the present status of laboratory services in SUS in 31 cities of Minas Gerais, Brazil, between 2008 and 2011. The present work reveals the deficiencies of public laboratory services in Minas Gerais, and proposes a new management model, which is able to associate operational quality, technological development and optimization of human and material resources with higher productivity. The Brazilian Unified Health System (SUS), created by the Federal Constitution of 1988(4), and ruled in 1990(5), aimed at the provision of universal, equal and integral access to health, with the participation of local community and emphasis in prevention. Doctorate in Tropical Medicine from Universidade Federal de Minas Gerais (UFMG); senior associate professor of Laboratory Medicine at UFMG. 4. Doctorate in Cellular and Molecular Biology from Fundação Oswaldo Cruz (Fiocruz); associate professor of Laboratory Medicine at UFMG
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