Rocha Paulo de Medeiros, de Sá Armando Brito
Departamento de Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN.
Cien Saude Colet. 2011 Jun;16(6):2853-63. doi: 10.1590/s1413-81232011000600023.
Primary healthcare in Portugal is undergoing a major reform, of which family health units (FHU) are one of the more visible results. This study aimed to evaluate the FHU implementation process from 2006 onwards. Methods from a previous study of primary healthcare implementation in Brazil were used. Dimensions studied included comprehensiveness of care, organization of care, and the political-institutional perspective. The main improvements identified included better availability of care, team work, technical quality of care, innovative management practices, sustainability of the model, working conditions and infrastructure improvements. Main challenges remaining include integration with hospital care, political and institutional gray areas, need for better information systems, integration within health centers and workflow organization. These data may be useful for management decision-makers when making adjustments and corrections in the reform process.
葡萄牙的初级医疗保健正在经历一场重大改革，家庭健康单位（FHU）是其中较为显著的成果之一。本研究旨在评估自2006年起FHU的实施过程。采用了先前一项关于巴西初级医疗保健实施情况研究的方法。所研究的维度包括医疗服务的全面性、护理组织以及政治 - 制度视角。所确定的主要改进包括医疗服务可及性提高、团队合作、医疗技术质量、创新管理实践、模式的可持续性、工作条件以及基础设施改善。仍然存在的主要挑战包括与医院护理的整合、政治和制度灰色地带、对更好信息系统的需求、在健康中心内部的整合以及工作流程组织。这些数据对于管理决策者在改革过程中进行调整和纠正可能会有所帮助。
