O espaço em movimento: o desvelar da rede nos processos sociotécnicos do sistema de saúde de Vitória da Conquista Bahia

• Autor(a) principal: Ferraz, Ana Emília de Quadros
• Data de Publicação: 2009
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: https://ri.ufs.br/handle/riufs/5421
• topic: Rede; Saúde; Geografia; Network; Healthcare; Geography; CNPQ::CIENCIAS HUMANAS::GEOGRAFIA

The objective in this thesis was to use the concept of a network, traditionally used from a geographic standpoint as it relates to technical infrastructure or to social analysis, to other aspects of the geographical landscape from both a social and technical standpoint. More than a simple word, network is a concept full of elements that, together, allow one to investigate or observe social and technical aspects in an unusual way. The network evokes terms such as: connectivity, fixtures, flows, fluidity, horizontality, verticality and others. It involves material and non-material elements in the same process, and is constructed and reconstructed in social relations, in a permanent vacillation between harmony and conflict over interests and necessities. The concept of a geographic network was used as a lens through which the complex healthcare system of Vitória da Conquista - Bahia could be analyzed. The analysis was performed through methodological procedures such as: bibliographical revision, empirical work, direct interviews and commentary, questionnaires and surveys of information sources. To organize the research it was necessary to prepare elaborate texts, maps, tables, graphs and projects. In the city, the phenomenon presents particular magnification of the interconnection of the units of healthcare equipment and services, in the movement and daily flow of patients, and the interwoven social patters and practices that both cause and react to ever changing circumstances. The healthcare networks involve more than the spatial distribution of equipment and its flows; it also represents the interests of the social elements that both participate in it and produce it. The current situation of the healthcare sector in Vitória da Conquista discloses different spatial temporality, as it is constantly evolving. Specifically, the process of the municipalization of the healthcare system there reveals the conflict between antagonistic interests of the State and the private sector. When the State applies new rules to contract services, it creates a crisis between the municipality-run healthcare and the rendering of services offered by private providers. Paradoxically, this crisis converts the private sector into a stronger force that perceives possibilities for capital accumulation, arising from the move to municipal-run healthcare. The inefficiency of the state system of healthcare vertiginously stimulates the private sector, which starts to invest especially in high complexity procedures to meet the shortfalls in government care. The conflict between opposite interests reveals the powerful relationships, actions and reactions that build the network that encompasses them. Similarly the State tries to control patient flows, causing the private sector search for ways to fortify and direct the flows of patients. With the study based on the concept of a geographic network, the resulting focus on fluidity demonstrated the importance to analyze the geographic fixtures and flows together, recognizing the interactions and implication of the movements instead of being deceived by the fixtures alone. The study indicated the categorical network allows the examination of the phenomenon in its different spatial temporality. The network constantly evolves, builds and rejuvenates itself from its myriad of participants and touch-points. In summary, each analyzed aspect, scale, space and time makes possible a new drawing of the geographical network and its infinitepossibilities for acknowledgment and analysis.