Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Universidade Federal Fluminense. Niterói RJ Brasil.
Cien Saude Colet. 2022 Jun;27(6):2481-2493. doi: 10.1590/1413-81232022276.15702021. Epub 2021 Nov 5.
The scope of the article was to characterize the process of regulation of care in Primary Health Care units in the city of Rio de Janeiro, with an emphasis on the outpatient dimension. A cross-sectional study was carried out in 2019, by means of a survey, with the participation of 114 local regulatory physicians. With respect to the profile of local regulators, there is a high percentage with training in Family and Community Medicine and the length of service of these professionals in the units is relatively satisfactory. For 52.6%, the infrastructure for regulation is adequate, but connectivity frequently presents problems. In the regulation system, the mechanisms and schedules for making vacancies available and accessing them elicit competition between the regulators of the units, with work overload and associated access inequities. There was major involvement of local regulators in activities of evaluation and management of waiting times. The majority reported that there was little or no interaction with specialized care. Although the decentralized regulation process still has some shortcomings, the study points to the feasibility and contribution of more intense participation of Primary Care in the regulation of access.
本文旨在描述里约热内卢市基层医疗保健单位护理监管过程,重点关注门诊层面。2019 年开展了一项横断面研究,采用问卷调查的方式,有 114 名当地监管医生参与。就当地监管者的概况而言,具有家庭和社区医学培训背景的比例较高,这些专业人员在单位的服务年限相对令人满意。对于 52.6%的人来说,监管基础设施是足够的,但连接经常存在问题。在监管系统中,空缺职位的机制和时间表以及获得这些职位的途径引发了单位监管者之间的竞争,导致工作负担过重和相关的准入不公平。当地监管者主要参与等待时间的评估和管理活动。大多数人报告说,他们与专科医疗的互动很少或没有。尽管分散的监管过程仍存在一些缺点,但该研究表明,基层医疗更积极地参与准入监管具有可行性和贡献。