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[急诊室的关注管理与联邦政府的作用]

[Management of attention to emergency rooms and the federal role].

作者信息

O'Dwyer Gisele

机构信息

Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21041-210.

出版信息

Cien Saude Colet. 2010 Aug;15(5):2395-404. doi: 10.1590/s1413-81232010000500014.

Abstract

Attention to the emergency care has been criticized, and since 2002 the Brazilian State has assumed the efforts to standardize the level of attention. It was proposed the analysis of documents and acts based on the Structuration Theory that considers the mobilization of allocative and authoritarian resources as dimensions of structure in interaction, which would justify the legitimacy exercised since the establishment of regulations. The National Emergency Plan (PNAU) had as guides: the federal funding, regionalization, professional education, management by urgency committees, and the expansion of the network. It was identified the density of the documental proposals as the facilitator trend of the structural resource, innovative due to the regionalization and responsibilization proposals presented by the several actors and by the alleged centrality of the user. The financing of SUS, despite its persistent state of embarrassment, had no coercive action on the technology investment. Under the current administration there was a vigorous expansion and structuring of the network, which was made by a strong inflow of federal funds. The management by committees should be investigated and points out how fragile the management of labor is.

摘要

对急诊护理的关注受到了批评,自2002年以来,巴西政府一直在努力规范护理水平。有人提议根据结构化理论对文件和行为进行分析,该理论将分配性资源和权威性资源的调动视为互动结构的维度,这将证明自法规制定以来所行使的合法性。国家应急计划(PNAU)的指导方针包括:联邦资金、区域化、专业教育、由紧急情况委员会管理以及网络扩展。文件提案的密集程度被确定为结构资源的促进趋势,由于多个行为体提出的区域化和责任分担提案以及所谓的用户中心地位,该趋势具有创新性。统一卫生系统(SUS)的融资尽管一直处于尴尬状态,但对技术投资没有强制性行动。在现任政府的领导下,网络得到了大力扩展和构建,这是由大量联邦资金流入实现的。委员会管理应受到调查,并指出劳动力管理有多薄弱。

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