Meneses Consuelo Sampaio, Cecilio Luiz Carlos de Oliveira, Andreazza Rosemarie, Carapinheiro Graça, Andrade Maria da Graça Garcia, Santiago Sílvia Maria, Araújo Eliane Cardoso, Souza Ana Lúcia Medeiros, Reis Denizi Oliveira, Pinto Nicanor Rodrigues da Silva, Spedo Sandra Maria
Departamento de Medicina Preventiva, Universidade Federal de São Paulo. R. Botucatu 740, Vila Clementino. 04023-062 São Paulo SP Brasil.
Instituto Superior de Ciências do Trabalho e da Empresa, Instituto Universitário de Lisboa. Lisboa Portugal.
Cien Saude Colet. 2017 Jun;22(6):2013-2024. doi: 10.1590/1413-81232017226.14822016.
This paper discusses part of the results obtained from a study carried out in two cities of the so-called ABCD Paulista Region in the period 2010-2012, in an attempt to spot the existence of non-state regulatory rationale towards access and consumption of health care services. The first stage includes interviews carried out with strategic stakeholders (managers and politicians) and key workers players. The second stage collected the stories of 18 very frequent users of health care services. This study revealed the leading role played by users to produce "health care maps", with emphasis on the frequent use of public and private resources in their itineraries, circumventing or merging with government regulation to obtain the care they need. The different formats of public-private mix transcend the still prevailing "official" concepts about the clear distinction between the two systems, which reveals the importance of this theme to public health management.