Factors associated to the access to health services from the point of view of professionals and users of basic reference unit

Abstract

This study aims to analyze the users' access to health services in a Basic Reference Unit (UBR) in a municipality of the metropolitan area of Belo Horizonte, Minas Gerais. The semi-structured interviews and questionnaire were conducted with 15 health professionals and 38 users respectively. The interviews addressed the local service, the health team, the users and the health services delivery network's characteristics. The questionnaire addressed users' sociodemographic and health characteristics. The interviews and questionnaires results analysis were presented on structural (financing, coverage), relational (comprehension of the health-illness process) and operational (service organization) dimensions. In the structural dimension, it was observed that the health system underfunding is a difficulty to the health services access and to the Family Health Strategy (ESF) implementation. In the relational dimension, it was observed that the lack of alignment regarding the structure and the health system operational flow impact negatively on the relationship between health professional and user. On the operational dimension, the health professionals and users reported significant shortcomings, such as the ESF coverage, appointment scheduling, reception, geographical barriers, referral and counter referral. The information obtained in this study is important to understand the factors associated to the health services access for the subject population and to help the developing strategies to improve the access.