Organization of health care actions: models and practices

Abstract

The objective of this paper is to discuss the recent conceptual contributions to the development of health care organization models. This is a critical essay, based on the Theory of Health Work Process, authored by Mendes-Gonçalves and collaborators, revisited under the philosophical perspective of contemporary Hermeneutics (Gadamer, Ricoeur, Habermas). Firstly, "model" is defined as the convergence of horizons of the diverse socially legitimated discourses on the modes of operation of technologies that provide health care for individuals and populations. Then, the principle of integrality of care within the context of Sistema Único de Saúde (Brazil's National Health System) and its challenges in the fields of knowledge, technologies and ethics are elected as the guiding path for the reflection. The concepts of vulnerability, care and humanization, viewed as recent proposals attempting at new discursive confluences for the construction of integral care models, are analyzed, focusing on their main assumptions and contents, and also on their practical achievements and challenges.