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初级卫生保健中的照护协调:巴西东北部一个市的评估研究

Care coordination in primary health care: an evaluative study in a municipality in the Northeast of Brazil.

作者信息

Aleluia Italo Ricardo Santos, Medina Maria Guadalupe, Almeida Patty Fidelis de, Vilasbôas Ana Luiza Queiroz

机构信息

Instituto de Saúde Coletiva, Universidade Federal da Bahia. R. Basílio da Gama, Canela. 40110-040 Salvador BA Brasil.

Departamento de Planejamento em Saúde, Instituto de Saúde Coletiva da Universidade Federal Fluminense. Niterói RJ Brasil.

出版信息

Cien Saude Colet. 2017 Jun;22(6):1845-1856. doi: 10.1590/1413-81232017226.02042017.

Abstract

International and Brazilian studies have highlighted the importance of the coordination of care for the organization of local health systems. This study aimed to analyze the coordination of care by Primary Health Care (PHC) in a municipal health system in the State of Bahia. This study was conducted in the lead municipality of the macro-region and involved two levels of analysis: PHC team and municipal management. Outlining conditions for the study were defined (hypertension and diabetes mellitus) and an objective image corresponding to the coordination of care was developed based on current national and international literature review. Semi-structured interviews with professionals, managers of PHC services were conducted and current documentary sources were also used. It was demonstrated that the coordination of care has not been met by municipal systems, where only 14 of the 22 proposed criteria have been met. The main difficulties and reasons were: a lack of health care protocols and the non-implementation of computer systems and telecommunication technologies. The results and the conceptual framework to assess the coordination of care are relevant contributions to this study, which can be applied to other contexts with similar characteristics.

摘要

国际和巴西的研究强调了医疗协调对于地方卫生系统组织的重要性。本研究旨在分析巴伊亚州一个市卫生系统中初级卫生保健(PHC)的医疗协调情况。该研究在宏观区域的主要城市进行,涉及两个分析层面:初级卫生保健团队和市政管理。确定了研究的概述条件(高血压和糖尿病),并基于当前的国内和国际文献综述,制定了与医疗协调相对应的客观形象。对初级卫生保健服务的专业人员、管理人员进行了半结构化访谈,并使用了当前的文献资料。结果表明,市政系统未实现医疗协调,在22项提议标准中仅满足了14项。主要困难和原因包括:缺乏医疗保健协议以及未实施计算机系统和电信技术。评估医疗协调的结果和概念框架是本研究的重要贡献,可应用于具有类似特征的其他背景。

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