Heimann Luiza Sterman, Ibanhes Lauro Cesar, Boaretto Roberta Cristina, Castro Iracema Ester do Nascimento, Telesi Júnior Emilio, Cortizo Carlos Tato, Fausto Márcia Cristina Rodrigues, do Nascimento Vânia Barbosa, Kayano Jorge
Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo, São Paulo 01314-000.
Cien Saude Colet. 2011 Jun;16(6):2877-87. doi: 10.1590/s1413-81232011000600025.
This paper presents some results of a case study in the Metropolitan Region of São Paulo (SP, Brazil) as part of a multicentric study conducted in Argentina, Brazil, Paraguay and Uruguay. The aim is to evaluate Primary Health Care (PHC) as a strategy to achieve integrated and universal healthcare systems. The methodological approach was based on five analytical dimensions: stewardship capability; financing; provision; comprehensiveness and intersectoral approach. The techniques included literature review, document analysis and interviews with key informants: policy makers; managers, experts, users and professionals. The results were organized in response to the challenges and possibilities of PHC as a structural system according to the five dimensions. The following emerged from the interviews: different interpretations on the concept and role of PHC and a consensus as the gateway to the system; weaknesses in funding; challenges in health workforce administration and the need for new legal-institutional design for regional management. The potential aspects were: broader coverage/universality, PHC as the basis for the organization of the system; connection with the territory and understanding specific population needs.
本文介绍了作为在阿根廷、巴西、巴拉圭和乌拉圭开展的多中心研究一部分，在巴西圣保罗大都市区进行的一项案例研究的一些结果。其目的是评估初级卫生保健（PHC）作为实现综合和全民医疗保健系统的一项战略。方法学方法基于五个分析维度：管理能力；筹资；服务提供；全面性和部门间方法。所采用的技术包括文献综述、文件分析以及与关键信息提供者（政策制定者、管理人员、专家、用户和专业人员）的访谈。根据这五个维度，针对初级卫生保健作为一个结构体系所面临的挑战和可能性对结果进行了整理。访谈得出以下结论：对初级卫生保健的概念和作用存在不同解释，并且达成了将其作为该系统入口的共识；资金方面的弱点；卫生人力管理方面的挑战以及对区域管理进行新的法律 - 制度设计的必要性。潜在的方面包括：更广泛的覆盖范围/全民性、初级卫生保健作为该系统组织的基础；与地域的联系以及对特定人群需求的理解。
