Guedes Bruno de Almeida Pessanha, Vale Fabiana Loureiro Binda do, Souza Rodrigo Wilson de, Costa Maria Katallini Alves, Batista Sandro Rodrigues
Diretoria de Atenção Secundária e Integração de Serviços, Subsecretaria de Atenção Integral à Saúde, Secretaria de Estado da Saúde do Distrito Federal. STN, Asa Norte. 70086-900 Brasília DF Brasil.
Secretaria Adjunta de Assistência, Secretaria de Estado da Saúde do Distrito Federal. Brasília DF Brasil.
Cien Saude Colet. 2019 Jun 27;24(6):2125-2134. doi: 10.1590/1413-81232018246.08632019.
Secondary Outpatient Care (SOC) is a subject seldom studied in the literature, but of great importance for the strengthening of Primary Health Care (PHC) and the structuring of the Health Care Network. After the increase of PHC coverage following the Family Health Strategy (FHS) model, through the "CONVERTE APS" project, the State Health Secretariat of the Federal District (SHS-DF) identified the need to organize this level of care throughout the Federal District. SHS-DF has, as its Health Care Planning basis, the knowledge experienced in one of its regions, in addition to the theoretical framework produced and systematized by the National Council of Health Secretariats (CONASS) in recent years, as well as successful experiences in other regions of Brazil and countries with public health systems. The strategies to be used include the following: diagnosis and organization of facility structures, creation of a regional managerial level for Secondary Care, personnel sizing, development of the legal framework for level of care regulation, creation of technical milestones, regulation of medical and non-medical consultations in health regions and matrix support as an education strategy, but also of connection between levels of care.
二级门诊护理(SOC)是文献中很少研究的一个课题,但对于加强初级卫生保健(PHC)和构建卫生保健网络非常重要。在通过“CONVERTE APS”项目采用家庭健康战略(FHS)模式扩大初级卫生保健覆盖范围之后,联邦区州卫生秘书处(SHS-DF)确定有必要在整个联邦区组织这一级别的护理。SHS-DF以其一个地区积累的经验为卫生保健规划基础,此外还借鉴了国家卫生秘书处理事会(CONASS)近年来制定并系统化的理论框架,以及巴西其他地区和拥有公共卫生系统国家的成功经验。拟采用的策略包括:设施结构的诊断和组织、设立二级护理区域管理级别、人员规模确定、制定护理级别监管法律框架、设立技术里程碑、规范卫生区域的医疗和非医疗咨询以及作为教育战略的矩阵支持,还有护理级别之间的联系。