Primary Health Care: care coordinator in regionalized networks?

Authors

  • Patty Fidelis de Almeida Universidade Federal Fluminense; Instituto de Saúde Coletiva; Departamento de Planejamento em Saúde
  • Adriano Maia dos Santos Universidade Federal da Bahia; Instituto Multidisciplinar em Saúde

DOI:

https://doi.org/10.1590/s1518-8787.2016050006602

Abstract

RESUMO OBJECTIVE To analyze the breadth of care coordination by Primary Health Care in three health regions. METHODS This is a quantitative and qualitative case study. Thirty-one semi-structured interviews with municipal, regional and state managers were carried out, besides a cross-sectional survey with the administration of questionnaires to physicians (74), nurses (127), and a representative sample of users (1,590) of Estratégia Saúde da Família (Family Health Strategy) in three municipal centers of health regions in the state of Bahia. RESULTS Primary Health Care as first contact of preference faced strong competition from hospital outpatient and emergency services outside the network. Issues related to access to and provision of specialized care were aggravated by dependence on the private sector in the regions, despite progress observed in institutionalizing flows starting out from Primary Health Care. The counter-referral system was deficient and interprofessional communication was scarce, especially concerning services provided by the contracted network. CONCLUSIONS Coordination capacity is affected both by the fragmentation of the regional network and intrinsic problems in Primary Health Care, which poorly supported in its essential attributes. Although the health regions have common problems, Primary Health Care remains a subject confined to municipal boundaries.

Published

2016-01-01

Issue

Section

Original Articles

How to Cite

Primary Health Care: care coordinator in regionalized networks? . (2016). Revista De Saúde Pública, 50, 80. https://doi.org/10.1590/s1518-8787.2016050006602