Silva Silvio Fernandes da
Conselho Nacional de Secretarias Municipais de Saúde, Brasília, DF 70058-900.
Cien Saude Colet. 2011 Jun;16(6):2753-62. doi: 10.1590/s1413-81232011000600014.
This article examines the causes of the segmentation/fragmentation in the healthcare process and the benefits of the constitution of networks set up to rationalize expenditures, optimize resources and ensure care tailored to the needs of the users. Its main purpose is to analyze the current challenges facing Brazil's Unified Health System, in order to promote improved integration between services. Among the challenges, those related to the insufficiency of resources due to low public funding, the training and education processes and their effects on the availability of health professionals to work in the public health system and the difficulties in the decentralization of health services and actions in the context of the Brazilian Federation Pact should be stressed. The paper concludes that, besides the efforts to tackle these challenges, the organization of regionalized networks integrated with the Unified Health System also depends on the improvement of intergovernmental management in the health regions to bolster the agreement on responsibilities among the government areas and the qualification of primary healthcare to coordinate care and ensure its continuity at other levels of the system.
本文探讨了医疗保健过程中分割/碎片化的成因,以及为使支出合理化、优化资源并确保根据用户需求提供个性化护理而建立的网络所带来的益处。其主要目的是分析巴西统一卫生系统目前面临的挑战,以促进服务之间更好的整合。在这些挑战中,应强调与公共资金不足导致资源短缺、培训和教育过程及其对公共卫生系统中卫生专业人员可用性的影响,以及在巴西联邦协议背景下卫生服务和行动的分权困难等相关问题。本文得出结论,除了努力应对这些挑战外,与统一卫生系统整合的区域化网络的组织还取决于改善卫生区域的政府间管理,以加强政府各部门之间在责任方面的共识,以及提高初级医疗保健的资质,以协调护理并确保在系统的其他层面上护理的连续性。