Health Care Planning: a method to organize and integrate healthcare networks

Abstract

Abstract Issue/problem Fragmentation of health care system is a concern in both developed and low and medium development countries, once may compromise cost-effectiveness, equity and quality of health care provision. Healthcare reforms have been focusing on integration, which is complex, considering that requires a methodology and involvement of actors from different sectors and governmental spheres. Description of the problem The “Health Care Planning” (HCP) method, proposed by the Brazilian National Council of Health Secretaries to overcome fragmentation of Brazil's public healthcare model, promotes development of local actors' skills and competences to organize healthcare networks through two main activities: (i) Workshops, provided to all health professionals aiming to introduce theoretical concepts and desire of changing; (ii) Tutoring, to guide theory implementation in healthcare services. A strategic group, composed of representatives of health services, managers and technical areas of health secretariats, monitors the whole process. Results Since 2018, the PlanificaSUS project is executed to implement the HCP in Brazil, focusing on integration of specialized outpatient care (SOC) with primary care (PC), in the context of healthcare network, coordinated by PC. From 27 health regions that agreed to participate, 25 (in 19 states and 282 municipalities) concluded the first phase in December 2020. Four thematic workshops were conducted with mean participation of 31.233 professionals each. Further, 316 local professionals were formed and conducted 2.131 tutoring activities in PC and 193 SOC. Improvement of PC organization was reported by 70% of PC facilities. In 76% of SOC facilities, team was completed and trained. Lessons HCP is an innovative method that could be applied in large-scale and adapted to provide healthcare services organization and integration according to local conditions. Autonomy of State and Municipal Health Secretariats must be encouraged. Key messages Health Care Planning is a potential method to provide qualification and integration of healthcare services in different contexts. Support from state management is important to develop organization and qualification of healthcare networks coordinated by the primary care.