Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém

Detalhes bibliográficos
Autor(a) principal: Bastos, Luzia Beatriz Rodrigues
Data de Publicação: 2019
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UFG
Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/9534
Resumo: INTRODUCTION. Regulatory structures can become determinants in the organizational process of health management, since it has the possibility of giving more effective responses to the requesting units and, above all, to the user. It would be up to the establishment of flows for the intended service not only implying optimization of expenses. Objective. To analyze the regulation of health services, in the Metropolitan Region I of the state of Pará, in view of complex and regulatory centers, recommended by the Brazilian Unified Health System (SUS). METHODOLOGY. An exploratory descriptive study with a mixed focus developed in the complexes and central regulators of the municipalities of Belém, Ananindeua, Marituba and Benevides, whose sample was composed of eighteen managers and seventy regulators, from September / 2017 to January 2018. It was applied the questionnaire in the first phase of the research and after that 40 semi-structured interviews were carried out. RESULTS. In the process of calculating the quantitative data it was found that the officials of the regulation, are female, with average age of 39 years; salary range of 2 minimum wages; majority of administrative assistants with effective ties. As limiting factors were found: great demand; lack of indication of priority cases and failure to refer to regulatory criteria; unavailability of beds, systemic difficulties in relation to the agreed services and the SISREG; difficult scheduling and execution procedures; increased demand for repressed elective procedures; problems in the flow of information between primary care and regulation, among others. As main potentialities in health regulation, the following stand out: increase of financial resources to health; reorganization of internal regulatory procedures; meeting the needs of users; health training for regulatory professionals, and strengthening of primary health care. CONCLUSION. The study showed that it is difficult to concentrate higher level professionals to perform the tasks of regulators of medium and high complexity procedures of SUS; there are obstacles in operationalizing the regulatory process, because the regulatory structures created coexist with insufficient resources, unconditional agreements with the reality of the municipalities of the north of the country; there is recognition of the need for a strong regulatory component by the State in guaranteeing qualified health access to the population, one of the greatest challenges being to understand the multiplicity of scenarios, subjects and interests, and to implement strategies focused on the user that needs health services.
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spelling Barbosa, Maria Alveshttp://lattes.cnpq.br/5025797873585225Barbosa, Maria AlvesDuarte, Célia ScapinNogueira, Douglas JoséFerreira, Ilma PastanaVila, Vanessa da Silva Carvalhohttp://lattes.cnpq.br/8625437490049872Bastos, Luzia Beatriz Rodrigues2019-04-25T15:20:14Z2019-03-11BASTOS, L. B. R. Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém. 2019. 137 f. Tese (Doutorado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2019.http://repositorio.bc.ufg.br/tede/handle/tede/9534INTRODUCTION. Regulatory structures can become determinants in the organizational process of health management, since it has the possibility of giving more effective responses to the requesting units and, above all, to the user. It would be up to the establishment of flows for the intended service not only implying optimization of expenses. Objective. To analyze the regulation of health services, in the Metropolitan Region I of the state of Pará, in view of complex and regulatory centers, recommended by the Brazilian Unified Health System (SUS). METHODOLOGY. An exploratory descriptive study with a mixed focus developed in the complexes and central regulators of the municipalities of Belém, Ananindeua, Marituba and Benevides, whose sample was composed of eighteen managers and seventy regulators, from September / 2017 to January 2018. It was applied the questionnaire in the first phase of the research and after that 40 semi-structured interviews were carried out. RESULTS. In the process of calculating the quantitative data it was found that the officials of the regulation, are female, with average age of 39 years; salary range of 2 minimum wages; majority of administrative assistants with effective ties. As limiting factors were found: great demand; lack of indication of priority cases and failure to refer to regulatory criteria; unavailability of beds, systemic difficulties in relation to the agreed services and the SISREG; difficult scheduling and execution procedures; increased demand for repressed elective procedures; problems in the flow of information between primary care and regulation, among others. As main potentialities in health regulation, the following stand out: increase of financial resources to health; reorganization of internal regulatory procedures; meeting the needs of users; health training for regulatory professionals, and strengthening of primary health care. CONCLUSION. The study showed that it is difficult to concentrate higher level professionals to perform the tasks of regulators of medium and high complexity procedures of SUS; there are obstacles in operationalizing the regulatory process, because the regulatory structures created coexist with insufficient resources, unconditional agreements with the reality of the municipalities of the north of the country; there is recognition of the need for a strong regulatory component by the State in guaranteeing qualified health access to the population, one of the greatest challenges being to understand the multiplicity of scenarios, subjects and interests, and to implement strategies focused on the user that needs health services.INTRODUÇÃO. As estruturas de regulação, podem se tornar determinantes no processo organizacional da gestão da saúde, pois tem a possibilidade de dar respostas mais efetivas às unidades solicitantes e, sobretudo, ao usuário. A ela caberia, o estabelecimento de fluxos para o atendimento almejado não implicando apenas em otimização de gastos. OBJETIVO. Analisar a regulação dos serviços de saúde, na Região Metropolitana I do estado do Pará, tendo em vista, complexos e centrais de regulação, preconizados pela legislação do Sistema Único de Saúde (SUS) METODOLOGIA. Estudo descritivo exploratório com enfoque misto desenvolvido nos complexos e centrais reguladores dos municípios de Belém, Ananindeua, Marituba e Benevides, cuja amostra foi composta por dezoito gestores e setenta profissionais de regulação, no período de setembro/2017 a janeiro de 2018. Aplicou-se o questionário na primeira fase da pesquisa e após foram realizadas 40 entrevistas semiestruturadas. RESULTADOS. No processo de apuração dos dados quantitativos constatou-se que os funcionários da regulação, são do sexo feminino, com idade média de 39 anos; faixa salarial de 2 salários mínimos; maioria composta de auxiliares administrativos com vínculo efetivo. Como fatores limitantes foram encontrados: grande demanda; falta de indicação dos casos prioritários e falha nos critérios de encaminhamento à regulação; indisponibilidade de leitos, dificuldades sistêmicas em relação aos serviços pactuados e ao SISREG; procedimentos de difícil agendamento e execução; aumento da demanda reprimida de procedimentos eletivos; problemas nos fluxos de informações entre a atenção primária e a regulação, dentre outros. Como principais potencialidades na regulação da saúde, destacam-se: incremento de recursos financeiros à saúde; reorganização dos procedimentos internos de regulação; atendimento das necessidades dos usuários; formação em saúde aos profissionais de regulação, e fortalecimento da atenção primária. CONCLUSÃO. O estudo demonstrou que há dificuldade em concentrar profissionais de nível superior para executar as tarefas de reguladores de procedimentos de média e alta complexidade do SUS; há entraves em operacionalizar o processo regulatório, pois as estruturas de regulação criadas convivem com recursos insuficientes, pactuações incondizentes com a realidade dos municípios do norte do país; há reconhecimento da necessidade de forte componente regulador por parte do Estado na garantia do acesso qualificado de saúde à população, sendo um dos maiores desafios compreender a multiplicidade de cenários, sujeitos e interesses, e de implementar estratégias centradas no usuário que necessita dos serviços de saúde.Submitted by Ana Caroline Costa (ana_caroline212@hotmail.com) on 2019-04-24T18:28:02Z No. of bitstreams: 2 Tese - Luzia Beatriz Rodrigues Bastos - 2019.pdf: 3923488 bytes, checksum: 4e745bf32f92feb5b79cfa318f02053b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2019-04-25T15:20:14Z (GMT) No. of bitstreams: 2 Tese - Luzia Beatriz Rodrigues Bastos - 2019.pdf: 3923488 bytes, checksum: 4e745bf32f92feb5b79cfa318f02053b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2019-04-25T15:20:14Z (GMT). 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dc.title.eng.fl_str_mv Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
dc.title.alternative.eng.fl_str_mv Regulation of health in the state of Pará: a study in the metropolitan region of Belém
title Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
spellingShingle Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
Bastos, Luzia Beatriz Rodrigues
Regulação
Saúde
Gestores
Profissionais
Sistema Único de Saúde
Regulation
Health
Managers
Professionals
CIENCIAS DA SAUDE::ENFERMAGEM
title_short Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
title_full Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
title_fullStr Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
title_full_unstemmed Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
title_sort Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém
author Bastos, Luzia Beatriz Rodrigues
author_facet Bastos, Luzia Beatriz Rodrigues
author_role author
dc.contributor.advisor1.fl_str_mv Barbosa, Maria Alves
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/5025797873585225
dc.contributor.referee1.fl_str_mv Barbosa, Maria Alves
dc.contributor.referee2.fl_str_mv Duarte, Célia Scapin
dc.contributor.referee3.fl_str_mv Nogueira, Douglas José
dc.contributor.referee4.fl_str_mv Ferreira, Ilma Pastana
dc.contributor.referee5.fl_str_mv Vila, Vanessa da Silva Carvalho
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/8625437490049872
dc.contributor.author.fl_str_mv Bastos, Luzia Beatriz Rodrigues
contributor_str_mv Barbosa, Maria Alves
Barbosa, Maria Alves
Duarte, Célia Scapin
Nogueira, Douglas José
Ferreira, Ilma Pastana
Vila, Vanessa da Silva Carvalho
dc.subject.por.fl_str_mv Regulação
Saúde
Gestores
Profissionais
Sistema Único de Saúde
topic Regulação
Saúde
Gestores
Profissionais
Sistema Único de Saúde
Regulation
Health
Managers
Professionals
CIENCIAS DA SAUDE::ENFERMAGEM
dc.subject.eng.fl_str_mv Regulation
Health
Managers
Professionals
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::ENFERMAGEM
description INTRODUCTION. Regulatory structures can become determinants in the organizational process of health management, since it has the possibility of giving more effective responses to the requesting units and, above all, to the user. It would be up to the establishment of flows for the intended service not only implying optimization of expenses. Objective. To analyze the regulation of health services, in the Metropolitan Region I of the state of Pará, in view of complex and regulatory centers, recommended by the Brazilian Unified Health System (SUS). METHODOLOGY. An exploratory descriptive study with a mixed focus developed in the complexes and central regulators of the municipalities of Belém, Ananindeua, Marituba and Benevides, whose sample was composed of eighteen managers and seventy regulators, from September / 2017 to January 2018. It was applied the questionnaire in the first phase of the research and after that 40 semi-structured interviews were carried out. RESULTS. In the process of calculating the quantitative data it was found that the officials of the regulation, are female, with average age of 39 years; salary range of 2 minimum wages; majority of administrative assistants with effective ties. As limiting factors were found: great demand; lack of indication of priority cases and failure to refer to regulatory criteria; unavailability of beds, systemic difficulties in relation to the agreed services and the SISREG; difficult scheduling and execution procedures; increased demand for repressed elective procedures; problems in the flow of information between primary care and regulation, among others. As main potentialities in health regulation, the following stand out: increase of financial resources to health; reorganization of internal regulatory procedures; meeting the needs of users; health training for regulatory professionals, and strengthening of primary health care. CONCLUSION. The study showed that it is difficult to concentrate higher level professionals to perform the tasks of regulators of medium and high complexity procedures of SUS; there are obstacles in operationalizing the regulatory process, because the regulatory structures created coexist with insufficient resources, unconditional agreements with the reality of the municipalities of the north of the country; there is recognition of the need for a strong regulatory component by the State in guaranteeing qualified health access to the population, one of the greatest challenges being to understand the multiplicity of scenarios, subjects and interests, and to implement strategies focused on the user that needs health services.
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-04-25T15:20:14Z
dc.date.issued.fl_str_mv 2019-03-11
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dc.identifier.citation.fl_str_mv BASTOS, L. B. R. Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém. 2019. 137 f. Tese (Doutorado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2019.
dc.identifier.uri.fl_str_mv http://repositorio.bc.ufg.br/tede/handle/tede/9534
identifier_str_mv BASTOS, L. B. R. Regulação da saúde no estado do Pará: um estudo na região metropolitana de Belém. 2019. 137 f. Tese (Doutorado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2019.
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