Cecilio Luiz Carlos de Oliveira, Andreazza Rosemarie, Carapinheiro Graça, Araújo Eliane Cardoso, de Oliveira Lissandra Andion, Andrade Maria da Graça Garcia, Meneses Consuelo Sampaio, Pinto Nicanor Rodrigues da Silva, Reis Denizi Oliveira, Santiago Silvia, de Souza Ana Lucia Medeiros, Spedo Sandra Maria
Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-Unifesp), R. Botucatu 740, Vila Clementino, 04023-062 São Paulo SP, Brazil.
Cien Saude Colet. 2012 Nov;17(11):2893-902. doi: 10.1590/s1413-81232012001100006.
The enhancement of primary healthcare has been a core strategy for the empowerment of the Brazilian Unified Health System (SUS). Recent guidelines issued by OPAS and the Ministry of Health highlight the role it has played as a thematic communication network center, a regulating agent for the access and use of services required for comprehensive healthcare. Sponsored by PPSUS/Fapesp, this study examines the possibilities of the primary healthcare network exercising such a strategic function. Life narratives involving 15 regular users were produced in two cities of ABC Paulista, which have adopted the Family Health Strategy for the organization of their primary healthcare networks. The study presents three main findings: the primary healthcare network serves as an outpost of SUS by producing user values even for high complexity service users; the primary network is perceived is a place for simple care needs; there is shared impotence between users and teams when it comes to the network functioning as the coordinator of care, indicating that it does not possess the technological, operational and organizational material conditions or symbolic conditions (values, meanings, and representations) to be in a central position in the coordination of thematic healthcare networks.
加强初级医疗保健一直是巴西统一卫生系统(SUS)赋权的核心战略。泛美卫生组织和巴西卫生部最近发布的指南强调了其作为主题交流网络中心所发挥的作用,即作为全面医疗服务所需服务获取和使用的调节机构。本研究由圣保罗州社会卫生保健计划/圣保罗研究基金会资助,探讨了初级医疗保健网络发挥这一战略功能的可能性。在圣保罗州ABC地区的两个城市,对15名普通用户进行了生活叙事,这两个城市采用了家庭健康战略来组织其初级医疗保健网络。该研究呈现了三个主要发现:初级医疗保健网络通过为高复杂性服务用户创造用户价值,成为SUS的前哨;初级网络被视为满足简单护理需求的场所;在网络作为护理协调者发挥作用方面,用户和团队之间存在共同的无力感,这表明它不具备在主题医疗保健网络协调中占据中心地位所需的技术、运营和组织物质条件或象征条件(价值观、意义和表象)。