Abstract
This paper discusses part of the results obtained from a study carried out in two cities of the so-called ABCD Paulista Region in the period 2010-2012, in an attempt to spot the existence of non-state regulatory rationale towards access and consumption of health care services. The first stage includes interviews carried out with strategic stakeholders (managers and politicians) and key workers players. The second stage collected the stories of 18 very frequent users of health care services. This study revealed the leading role played by users to produce "health care maps", with emphasis on the frequent use of public and private resources in their itineraries, circumventing or merging with government regulation to obtain the care they need. The different formats of public-private mix transcend the still prevailing "official" concepts about the clear distinction between the two systems, which reveals the importance of this theme to public health management.
Highlights
Qualitative studies conducted from the users’ perspective point to their ability to produce strategies to overcome the obstacles found in the intricate formal flows of the health system, evidencing their leading role in obtaining care and their importance as subjects of knowledge[1,2,3,4]
This paper discusses part of the results obtained from a study carried out in two cities of the so-called ABCD Paulista Region in the period 2010-2012, in an attempt to spot the existence of non-state regulatory rationale towards access and consumption of health care services
This study revealed the leading role played by users to produce “health care maps”, with emphasis on the frequent use of public and private resources in their itineraries, circumventing or merging with government regulation to obtain the care they need
Summary
Qualitative studies conducted from the users’ perspective point to their ability to produce strategies to overcome the obstacles found in the intricate formal flows of the health system, evidencing their leading role in obtaining care and their importance as subjects of knowledge[1,2,3,4] Investigations show that they are carriers of a “lay rationality” and, do not act, in the search for care, in a “wild” or irrational way, due to lack of knowledge, intentionality or directionality[1,2,3,4], as pointed out in the research that provided the empirical data for this paper[1].
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