Integral care and attention to emergency: the mobile emergency care service in the state of Rio de Janeiro

Abstract

Emergency inadequate care is a matter of dissatisfaction for the population and increases morbidity and mortality. The SAMU (Mobile Emergency Care Service) was the first component of the National Emergency Policy to be deployed; this public policy proposes integral care of emergencies. In order to examine the practices of integral care at SAMU we analyzed its regulation in the state of Rio de Janeiro. The methodology was based on the strategic conduct analysis (Giddens, 1984), relating the agents and their strategies with the structural dimensions. The categorization of the analysis highlighted: the successful SAMU, with integral care practices in their individual component and access to services; its function as observatory of the network of health services, indicating restriction on access to the Family Health Program and the hospital; insufficiency of resources and inappropriate use of ambulances; and unrecognized demands, in which there was refusal of cases. The field work confirmed the power of SAMU as a health care observer. However, the authoritative resource mobilization and resource allocation were insufficient for an integrated system of emergencies care.