Regionalização da assistência à saúde : um estudo dos limites à implantação da Norma Operacional de Assistência à Saúde - NOAS na região norte do estado do Rio de Janeiro

• Autor(a) principal: Oliveira, Jaira Calil Siqueira de
• Data de Publicação: 2006
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal Fluminense (RIUFF)
• Texto Completo: https://app.uff.br/riuff/handle/1/19023
• topic: Saúde pública; Política de saúde; CNPQ::CIENCIAS SOCIAIS APLICADAS::SERVICO SOCIAL

After the publication of the Operational Rule of the Health Care (NOAS), the regionalization assumes an important role on the magnification to the health service at several levels of complexity of the system. This project evaluates the process of regionalization in the North Region of the State of Rio de Janeiro, composed by nine cities, such as: Campos dos Goytacazes, Carapebus, Cardoso Moreira, Conceição de Macabu, Macaé, Quissamã, São Fidélis, São Francisco de Itabapoana and São João da Barra. Therefore, various questions were approached, such as: the installed capacity for the health service, the comparative between the recommended quantitative and the existent quantitative (a constant of a database from SUS); the social participation concerning the controversies about the assistance model that must be regionally adopted; political will and credibility of the administrator compared to the implementation of the Rule, evaluated from an analysis of results obtained with the application of a questionnaire to the Health Secretaries from the region; discussions about the floating of the assistance and approaches of the process of first aid and nosocomial invoicing from the cities from Campos dos Goytacazes and Macaé, health poles of the region. The analyses demonstrate the existence of significative obstruction to the implantation of NOAS. These ones roamed over the disobedience of the Constitutional Amendment number 29 by the involved cities; by the insufficiency of the financial resource in 2002, 2003 and 2004, for the support of the health assistance both of first aid and nosocomial in the pole of Campos dos Goytacazes, and just for the first aid area in Macaé; by the sum of the own financial resources applicated in health by the cities and the existent interconnection with the installed capacity of the actual services, proving that the low supply is directly associated with the biggest cost of health, basing the assistance assurance on the private character; the role of the Health Secretary of the State in the process of distribution of financial resources to the cities non qualified in ample management of the municipal system, using bad defined criteria for such destination, contributing to the unknown by the municipal managers and by the own Commission Among Managers , of interfaces which involve the invoicing system. Finally, up against the demonstration of insufficiency of such resources in view of the local reality, we have approached some alternatives to minimize the actual situation, which some of them roam the co-operation among managers, the active social participation and the creation of a regional financial limit.