Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil,
Cien Saude Colet. 2020 May;25(5):1799-1808. doi: 10.1590/1413-81232020255.34122019. Epub 2020 May 8.
The objective of this article is to investigate the viewpoint of health professionals regarding the coordination of care in Primary Health Care (PHC) and the challenges for performing it. Qualitative research with professionals from two PHC teams working in territories with vulnerabilities and inequalities in Rio de Janeiro. Use of the Content Analysis method, thematic modality with semi-structured interviews and participant observation. To coordinate care is to be involved with the activities that foster the provision of individualized and comprehensive care, aiming at the care continuity. The challenges of coordinating care by the PHC are overcoming the network fragmentation, the low supply of openings for specialists, the fragile communication between the services, the non-integrated electronic medical record, the low professional qualification and the unawareness of the PHC role by other services. The strengthening of the PHC as the gateway, coordinator and organizer of the network requires efforts by managers, professionals and society, so this way of organizing the systems can bring benefits regarding equity, accessibility, clinical and sanitary effectiveness, economic efficiency and allow care integration.
本文旨在探讨卫生专业人员对初级卫生保健（PHC）中协调护理的观点，以及执行协调护理所面临的挑战。这是一项针对里约热内卢两个具有脆弱性和不平等性的地区的 PHC 团队的专业人员进行的定性研究。采用内容分析法，以半结构化访谈和参与式观察为主题模式。协调护理就是参与促进提供个性化和全面护理的活动，旨在实现护理的连续性。PHC 协调护理的挑战包括克服网络碎片化、专科门诊供应不足、服务间沟通不畅、电子病历不完整、专业人员素质低以及其他服务对 PHC 角色的认识不足。加强 PHC 作为网络的门户、协调者和组织者，需要管理者、专业人员和社会的共同努力，因此，这种系统组织方式可以在公平性、可及性、临床和卫生效果、经济效率方面带来好处，并实现护理一体化。
