PhD. Nurse, Adjunct Professor, Department of Nursing, Faculty of Agricultural, Biological, Engineering and Health Sciences, Universidade do Estado de Mato Grosso (UNEMAT), Tangará da Serra (MT), Brazil.
Msc. Nurse, Department of General and Specialized Nursing, Ribeirão Preto School of Nursing, Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil.
Sao Paulo Med J. 2024 Mar 11;142(4):e2023078. doi: 10.1590/1516-3180.2023.0078.R1.29112023. eCollection 2024.
Viral hepatitis is a major public health concern worldwide.
This study aimed to analyze the factors that facilitate access to care for viral hepatitis.
Using a sequential mixed method, this evaluation research was conducted in the state of Mato Grosso, Brazil.
Mapping of references and selection of regions were made based on the quantity and heterogeneity of services. The stakeholders, including the managers of the State Department of Health and professionals from reference services, were identified. Nine semi-structured interviews were conducted using content analysis and discussions guided by the dimensions of the analysis model of universal access to health services.
In the political dimension, decentralizing services and adhering to the Intermunicipal Health Consortium are highly encouraged. In the economic-social dimension, a commitment exists to allocate public funds for the expansion of referral services and subsidies to support users in their travel for appointments, medications, and examinations. In the organizational dimension, the availability of inputs for testing, definition of user flow, ease of scheduling appointments, coordination by primary care in testing, collaboration following the guidelines and protocols, and engagement in extramural activities are guaranteed. In the technical dimension, professionals actively commit to the service and offer different opening hours, guarantee the presence of an infectious physician, expand training opportunities, and establish intersectoral partnerships. In the symbolic dimension, professionals actively listen to the experiences of users throughout their care trajectory and demonstrate empathy.
The results are crucial for improving comprehensiveness, but necessitate managerial efforts to enhance regional governance.
病毒性肝炎是全球主要的公共卫生关注点。
本研究旨在分析促进病毒性肝炎患者获得医疗服务的因素。
采用序贯混合方法，在巴西马托格罗索州进行了这项评价性研究。
根据服务的数量和异质性进行参考资料的制图和区域选择。确定了利益攸关方，包括州卫生局的管理人员和参考服务的专业人员。使用内容分析和以卫生服务普遍获得分析模型的维度为指导的讨论，进行了九次半结构访谈。
在政治层面，高度鼓励服务去中心化并遵守市际卫生联合会。在经济社会层面，承诺分配公共资金以扩大转诊服务，并为用户提供旅行补贴，以支持他们预约、用药和检查。在组织层面，保证提供测试所需的投入、定义用户流程、方便预约、初级保健机构在测试方面的协调、按照指南和协议进行合作以及开展院外活动。在技术层面，专业人员积极投入服务，并提供不同的工作时间、保证传染病医生的在场、扩大培训机会以及建立部门间伙伴关系。在象征层面，专业人员在患者的整个护理过程中积极倾听他们的经历并表现出同理心。
这些结果对于提高综合性至关重要，但需要管理层努力加强区域治理。
