Godoi Heloisa, Andrade Selma Regina de, Mello Ana Lúcia Schaefer Ferreira de
Universidade Federal de Santa Catarina, Florianópolis, Brasil.
Cad Saude Publica. 2017 Sep 28;33(9):e00133516. doi: 10.1590/0102-311X00133516.
: The objective was to describe the governance system used in structuring the regionalized healthcare network in Santa Catarina State, Brazil, based on the Bipartite Inter-Managerial Commission (CIB), with a focus on structuring of oral healthcare. This was a qualitative, exploratory-descriptive documental study, based on the foundations of governance as an analytical tool through identification of the dimensions actors, norms, nodal points, and processes. Secondary data were collected from the minutes of CIB meetings held from January 2011 to December 2015. The analysis shows weaknesses in CIB governance in Santa Catarina in relation to regionalized structuring of oral healthcare from a network perspective. Structuring of oral healthcare occurs in parallel to that of other thematic networks in the state and shows the expansion of dental services, especially those with medium complexity, as an effect of the prevailing governance process. The relations established between administrators and decision-making processes allowed recognizing this network's "prescription", since there is little negotiation and local demand, limited more to following recommendations and incentives from the federal/state sphere, intermediated by staff from the State Health Secretariat. Thus, setting a policy agenda for oral healthcare for the population of Santa Catarina is weakened, with a peripheral position in relation to other health programs.
目的是描述巴西圣卡塔琳娜州基于双边管理委员会(CIB)构建区域化医疗网络时所采用的治理体系,重点是口腔医疗保健的构建。这是一项定性的探索性描述性文献研究,基于治理基础,将其作为一种分析工具,通过识别行为者、规范、节点和流程等维度。从2011年1月至2015年12月举行的CIB会议记录中收集二手数据。分析表明,从网络角度来看,圣卡塔琳娜州CIB在口腔医疗保健区域化构建方面的治理存在弱点。口腔医疗保健的构建与该州其他主题网络并行进行,并且显示出牙科服务的扩展,尤其是中等复杂性的服务,这是现行治理过程的结果。管理人员与决策过程之间建立的关系使得能够识别该网络的“规定”,因为几乎没有协商和当地需求,更多地局限于遵循联邦/州层面的建议和激励措施,由州卫生秘书处的工作人员进行协调。因此,为圣卡塔琳娜州民众制定口腔医疗保健政策议程的工作受到削弱,在与其他卫生项目的关系中处于边缘地位。