Coordenação do cuidado na atenção primária à saúde: estudo avaliativo em município sede de macrorregião do nordeste brasileiro

Abstract

International and Brazilian studies have highlighted the importance of the coordination of care for the organization of local health systems. This study aimed to analyze the coordination of care by Primary Health Care (PHC) in a municipal health system in the State of Bahia. This study was conducted in the lead municipality of the macro-region and involved two levels of analysis: PHC team and municipal management. Outlining conditions for the study were defined (hypertension and diabetes mellitus) and an objective image corresponding to the coordination of care was developed based on current national and international literature review. Semi-structured interviews with professionals, managers of PHC services were conducted and current documentary sources were also used. It was demonstrated that the coordination of care has not been met by municipal systems, where only 14 of the 22 proposed criteria have been met. The main difficulties and reasons were: a lack of health care protocols and the non-implementation of computer systems and telecommunication technologies. The results and the conceptual framework to assess the coordination of care are relevant contributions to this study, which can be applied to other contexts with similar characteristics.

Therapeutic itineraries for patients with cerebrovascular accident: fragmentation of care in a regionalized health network

“…The forms to have access and the offering of services in the PEBA interstate region is still characterized by an unorganized and uncoordinated care, showing organizational weaknesses in health regionalized networks linked to the Country and, theoretically, in a construction phase in the region studied. This research confirms findings of previous studies the very own regionalization process, which marks the low of coordination and planning actions, especially from the APS, [26][27][28] as well as other more recent studies that test the fragility of the articulation between the levels of care in regional networks, a recognized fact by managers themselves in another health region in São Paulo State. 29 It should be noted that the presence of the University Hospital in the region is a critical component for the patients' care who were affected by AVE. With all the obstacles in care present in the therapeutic itineraries analyzed in this study, the University Hospital of Traumas has allowed the access of the interviewed healthcare users who arrive at the emergency department, through formal or informal ways, from the two macro-regions that link the interstate health region.…”

Predictors of readmission and long length of stay in elders admitted with neurological disorders in a tertiary center: a real-world investigation

“…Arterial hypertension was the most common comorbidity and a strong predictor for long LOS in this population, and it may be due to patients (elders) suffering from long-term arterial hypertension 39 . Arterial hypertension is a long-lasting disorder, and its control depends on adequate primary care, which is underprovided in Bahia, northeastern Brazil 40 . Comorbidities were the leading risk for long LOS in these elderly neurological patients; thus, patient multimorbidity needs to be better studied in this population.…”

Knowledge and practices of Primary Care professionals on diabetic neuropathy: study of social representations

“…In the context of FHS, Chronic Noncommunicable Diseases (NCDs) represent an important group of diseases, demanding attention from the entire team, in view of their potential clinical repercussions, which affect individuals' and families' daily lives, in different spectra. The number of people living with NCDs has grown, especially in developing countries, posing a major challenge to health systems (4) .…”