A atenção especializada e as unidades móveis de saúde na perspectiva da integralidade do cuidado
Data
2018-08-29
Autores
Almeida, Luciane Cristiano de 
Orientadores
Casetto, Sidnei José
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
No Sistema Único de Saúde, os serviços de Atenção Básica devem coordenar os cuidados aos usuários que vivem e moram em determinado território, sendo importante a articulação e a integração com demais serviços especializados, diagnósticos e hospitalares para atender as necessidades de saúde da população. No Brasil, historicamente, no entanto, há insuficiente oferta de serviços especializados, e as Unidades Móveis em Saúde (UMS) surgem como uma das várias estratégias para ampliar a oferta de atendimentos especializados à população. Em diversos municípios, empresas são contratadas, por meio de licitação, com o intuito de ofertar exames, consultas especializadas e pequenas cirurgias, em UMS, de modo a reduzir o tempo de espera para esses atendimentos. Esta investigação partiu da hipótese de que há dificuldades de articulação entre a Atenção Básica e as UMS, manifestas por problemas de encaminhamento e de contrarreferência, o que produziria efeitos significativos no alcance da integralidade do cuidado. Este estudo buscou analisar, na perspectiva dos trabalhadores, a articulação entre a Atenção Básica e as UMS e seus efeitos na produção do cuidado. Foi utilizada a abordagem qualitativa, sendo que os dados foram coletados por meio de entrevistas semiestruturadas. A técnica para recrutar os sujeitos foi a bola de neve (snowball ou chain sampling). Foram entrevistados dez profissionais que trabalham na Atenção Básica e que tiveram alguma experiência de encaminhamento de usuários para UMS. A análise dos dados das entrevistas levou à constituição de quatro grandes categorias: <Oferta do serviço e agendamento=, <Acesso=, <Condições de atendimento=, e <Dificuldades de seguimento=. Os resultados confirmaram a hipótese inicial, tendo sido identificados problemas relativos à articulação entre os serviços, às condições de acesso às unidades, ao estabelecimento de metas de produção, à dificuldade de continuidade do tratamento de pacientes, dentre outros.
In the Unified Health System, Primary Care services should coordinate the care provided to users who live and reside in a given territory, and coordination and integration with other specialized, diagnostic, and hospital services are important to meet the health care needs of the population. In Brazil, historically, however, there is insufficient provision of specialized services, and Mobile Health Units (MHU) emerge as one of the several strategies to expand the provision of specialized care to the population. In several municipalities, private service providers are contracted, through government procurement, to provide examinations, specialized medical consultations and minor surgery, in MHUs, in order to reduce the waiting time for these services. This research was based on the hypothesis that there are difficulties of coordination between Primary Care and MHUs, observed in referral and counterreferral issues, which would produce significant effects on the outreach of the integrality of care. This study sought to examine, from the perspective of workers, the coordination between Primary Care and MHUs and its effects on the provision of care. Qualitative approach was used, and data were collected through semi-structured interviews. Subjects were recruited by using the snowball or chain sampling technique. We interviewed ten professionals who worked in Primary Care and who had some experience with user referral to MHUs. Analysis of interview data led to the establishment of four major categories: "Service provision and schedule," "Access," "Conditions of service," and "Difficulties of follow-up." The results confirmed the initial hypothesis, and we observed problems related to coordination between the services, to conditions of access to units, to establishment of provision goals, to difficulty of follow-up treatment of patients, among others.
In the Unified Health System, Primary Care services should coordinate the care provided to users who live and reside in a given territory, and coordination and integration with other specialized, diagnostic, and hospital services are important to meet the health care needs of the population. In Brazil, historically, however, there is insufficient provision of specialized services, and Mobile Health Units (MHU) emerge as one of the several strategies to expand the provision of specialized care to the population. In several municipalities, private service providers are contracted, through government procurement, to provide examinations, specialized medical consultations and minor surgery, in MHUs, in order to reduce the waiting time for these services. This research was based on the hypothesis that there are difficulties of coordination between Primary Care and MHUs, observed in referral and counterreferral issues, which would produce significant effects on the outreach of the integrality of care. This study sought to examine, from the perspective of workers, the coordination between Primary Care and MHUs and its effects on the provision of care. Qualitative approach was used, and data were collected through semi-structured interviews. Subjects were recruited by using the snowball or chain sampling technique. We interviewed ten professionals who worked in Primary Care and who had some experience with user referral to MHUs. Analysis of interview data led to the establishment of four major categories: "Service provision and schedule," "Access," "Conditions of service," and "Difficulties of follow-up." The results confirmed the initial hypothesis, and we observed problems related to coordination between the services, to conditions of access to units, to establishment of provision goals, to difficulty of follow-up treatment of patients, among others.
Descrição
Citação
ALMEIDA, Luciane Cristiano de. A atenção especializada e as unidades móveis de saúde na perspectiva da integralidade do cuidado. 2018. 67f. Dissertação (Mestrado profissional em Ensino em Ciências da Saúde) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2018