Tofani Luís Fernando Nogueira, Rebequi Andressa, Guimarães Cristian Fabiano, Furtado Lumena Almeida Castro, Andreazza Rosemarie, Chioro Arthur
Universidade Federal de São Paulo, São Paulo, Brasil.
Cad Saude Publica. 2023 Feb 10;39(1):e00161222. doi: 10.1590/0102-311XPT161222. eCollection 2023.
The study analyzes regulatory aspects and measures as social production in the Emergency Care Network (RUE) of two health regions. This is a multiple case study of qualitative character, performed via 61 interviews with public administrators, users, and health services managers. The analysis had as theoretical reference the Theory of Social Production. We identified professional, lay, clientelistic, and governmental regulatory measures, in the systemic aspects, of the services and of access. The main results point to regulatory flows produced by movements of various social actors, with emphasis on the action of representatives of hospital service providers, especially private ones, characterizing the proposal of another regime: market regulation. We emphasize the limits and powers of arrangements, such as hospital and the Mobile Emergency Care Service (SAMU) regulation centers, the internal hospital regulation centers, and the use of WhatsApp. Health regulation in RUE consists of complex, contradictory, and conflicting social processes, whose flows are produced at the limit between the public and private interests.
该研究分析了两个卫生区域的急诊护理网络(RUE)中作为社会生产的监管方面和措施。这是一项定性的多案例研究,通过对公共管理人员、用户和卫生服务经理进行61次访谈来开展。该分析以社会生产理论作为理论参考。我们在服务和准入的系统层面识别出了专业、外行、庇护主义和政府监管措施。主要结果表明,各种社会行为者的行动产生了监管流程,尤其强调医院服务提供者(特别是私立提供者)代表的行动,这构成了另一种制度提议的特征:市场监管。我们强调了诸如医院和移动急诊护理服务(SAMU)监管中心、医院内部监管中心以及WhatsApp使用等安排的局限性和权力。RUE中的卫生监管由复杂、矛盾和冲突的社会过程组成,其流程在公共利益和私人利益的界限处产生。