Coordenação do cuidado na atenção primária à saúde: estudo avaliativo em município sede de macrorregião do nordeste brasileiro

Italo Ricardo Santos Aleluia,Patty Fidelis De Almeida,Maria Guadalupe Medina,Ana Luiza Queiroz Vilasbôas

doi:10.1590/1413-81232017226.02042017

Italo Ricardo Santos Aleluia, Patty Fidelis De Almeida + Show 2 more

Open Access

https://doi.org/10.1590/1413-81232017226.02042017

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Abstract

International and Brazilian studies have highlighted the importance of the coordination of care for the organization of local health systems. This study aimed to analyze the coordination of care by Primary Health Care (PHC) in a municipal health system in the State of Bahia. This study was conducted in the lead municipality of the macro-region and involved two levels of analysis: PHC team and municipal management. Outlining conditions for the study were defined (hypertension and diabetes mellitus) and an objective image corresponding to the coordination of care was developed based on current national and international literature review. Semi-structured interviews with professionals, managers of PHC services were conducted and current documentary sources were also used. It was demonstrated that the coordination of care has not been met by municipal systems, where only 14 of the 22 proposed criteria have been met. The main difficulties and reasons were: a lack of health care protocols and the non-implementation of computer systems and telecommunication technologies. The results and the conceptual framework to assess the coordination of care are relevant contributions to this study, which can be applied to other contexts with similar characteristics.

Highlights

The high prevalence of chronic conditions in Brazil has made it necessary for there to be reforms in the organization of health services with a view to improving integration[1,2]
This study permits the appointing of obstacles for the coordination of care by the Primary Health Care (PHC) in a municipal health system based on an innovative methodology and based on a national and international review that is current
The obstacles to coordinating care that was shown, varies in relation to the questions related to the work process of the teams and the questions connected to the organization of the offer in the service network and support of the municipal management

Summary

Introduction

The high prevalence of chronic conditions in Brazil has made it necessary for there to be reforms in the organization of health services with a view to improving integration[1,2]. The coordination of care in Primary Health Care (PHC) has been internationally recognized as fundamental in the organization of health systems in order to obtain improvements in the provision of care. This is in terms of access, quality and the continuity of primary care either through the integration of services and actions between different levels or at the same level in the health system[1,2,3,4,5,6]. Other ramifications include: long waiting lists, duplication of diagnosis tests and unnecessary hospitalizations[1,7]

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