Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente
Autor(a) principal: | |
---|---|
Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/219186 |
Resumo: | OBJECTIVE: To depict the influence of discretionary actions exercised by frontline professionals and organizations on the implementation of diverse modalities of access to specialized dental care within the Care Network for Persons with Disabilities. METHODS: A case study conducted in two Brazilian health regions characterized by distinct means of access to specialized dental care employing documentary analysis and interviews with key stakeholders across the period spanning from July to December 2019. RESULTS: In the referenced access region, there was a notable centrality of Primary Health Care (PHC) in caregiving, wherein planning and assessment were integral components of institutional routines. Where spontaneous demand scheduling was accepted, sporadic exchanges of information were evident between PHC units and specialized facilities. The coordination role in caregiving was not vested in PHC teams, and activities such as planning and assessment were not assimilated into organizational routines. CONCLUSIONS: The implementation of policies for specialized dental care for persons with disabilities relied on the coordination furnished by PHC and the orchestration of planning and assessment endeavors aimed at establishing an integrated care network. This implementation proved subject to the discretionary authority of frontline professionals and organizations, highlighting the significant role of relational and institutional environments in the context of public policy implementation within a decentralized and regionalized healthcare system. |
id |
USP-23_4d35c2865591ab12e90316477f9c24c9 |
---|---|
oai_identifier_str |
oai:revistas.usp.br:article/219186 |
network_acronym_str |
USP-23 |
network_name_str |
Revista de Saúde Pública |
repository_id_str |
|
spelling |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frenteDental care for persons with disabilities: discretion on the frontlinePublic PolicyDental CareDisabled PersonsPolítica PúblicaAssistência Odontológica Pessoas com DeficiênciaOBJECTIVE: To depict the influence of discretionary actions exercised by frontline professionals and organizations on the implementation of diverse modalities of access to specialized dental care within the Care Network for Persons with Disabilities. METHODS: A case study conducted in two Brazilian health regions characterized by distinct means of access to specialized dental care employing documentary analysis and interviews with key stakeholders across the period spanning from July to December 2019. RESULTS: In the referenced access region, there was a notable centrality of Primary Health Care (PHC) in caregiving, wherein planning and assessment were integral components of institutional routines. Where spontaneous demand scheduling was accepted, sporadic exchanges of information were evident between PHC units and specialized facilities. The coordination role in caregiving was not vested in PHC teams, and activities such as planning and assessment were not assimilated into organizational routines. CONCLUSIONS: The implementation of policies for specialized dental care for persons with disabilities relied on the coordination furnished by PHC and the orchestration of planning and assessment endeavors aimed at establishing an integrated care network. This implementation proved subject to the discretionary authority of frontline professionals and organizations, highlighting the significant role of relational and institutional environments in the context of public policy implementation within a decentralized and regionalized healthcare system.OBJETIVO: Descrever a influência da discricionariedade dos profissionais e organizações da linha de frente na implementação de diferentes formas de acesso à assistência odontológica especializada na Rede de Cuidados à Pessoa com Deficiência. MÉTODOS: Estudo de caso em duas regiões de saúde brasileiras cujo acesso à assistência odontológica especializada era distinto, com análise documental e entrevista com atores-chave, entre julho e dezembro de 2019. RESULTADOS: Na região com acesso referenciado, observou-se que a atenção primária à saúde (APS) tinha centralidade no cuidado e o planejamento/avaliação faziam parte da rotina institucional dos serviços. Na região onde o agendamento era possível por demanda espontânea, notou-se trocas episódicas de informação entre as unidades de APS e as especializadas; o papel de coordenação do cuidado não era um atributo das equipes de APS e as atividades de planejamento/avaliação não estavam incorporadas à rotina das organizações. CONCLUSÕES: A implementação da política de assistência odontológica especializada à pessoa com deficiência se mostrou dependente da coordenação da APS e da condução de atividades de planejamento/avaliação voltadas à construção de uma rede de cuidados integrada e sujeita ao poder discricionário dos profissionais e das organizações da linha de frente, sugerindo que o ambiente relacional e institucional possui um papel importante no processo de implementação de políticas públicas em um sistema descentralizado e regionalizado de saúde.Universidade de São Paulo. Faculdade de Saúde Pública2023-09-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/21918610.11606/s1518-8787.2023057005318Revista de Saúde Pública; Vol. 57 No. 1 (2023); 74Revista de Saúde Pública; Vol. 57 Núm. 1 (2023); 74Revista de Saúde Pública; v. 57 n. 1 (2023); 741518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/219186/200109https://www.revistas.usp.br/rsp/article/view/219186/200108https://www.revistas.usp.br/rsp/article/view/219186/200107Copyright (c) 2023 Joana Danielle Brandão Carneiro, Ana Paula Chancharulo de Moraes Pereira, Aylene Bousquat, Paulo Frazãohttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCarneiro, Joana Danielle BrandãoPereira, Ana Paula Chancharulo de MoraesBousquat, AyleneFrazão, Paulo2023-11-24T17:28:44Zoai:revistas.usp.br:article/219186Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2023-11-24T17:28:44Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente Dental care for persons with disabilities: discretion on the frontline |
title |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente |
spellingShingle |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente Carneiro, Joana Danielle Brandão Public Policy Dental Care Disabled Persons Política Pública Assistência Odontológica Pessoas com Deficiência |
title_short |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente |
title_full |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente |
title_fullStr |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente |
title_full_unstemmed |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente |
title_sort |
Assistência odontológica à pessoa com deficiência: discricionariedade na linha de frente |
author |
Carneiro, Joana Danielle Brandão |
author_facet |
Carneiro, Joana Danielle Brandão Pereira, Ana Paula Chancharulo de Moraes Bousquat, Aylene Frazão, Paulo |
author_role |
author |
author2 |
Pereira, Ana Paula Chancharulo de Moraes Bousquat, Aylene Frazão, Paulo |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Carneiro, Joana Danielle Brandão Pereira, Ana Paula Chancharulo de Moraes Bousquat, Aylene Frazão, Paulo |
dc.subject.por.fl_str_mv |
Public Policy Dental Care Disabled Persons Política Pública Assistência Odontológica Pessoas com Deficiência |
topic |
Public Policy Dental Care Disabled Persons Política Pública Assistência Odontológica Pessoas com Deficiência |
description |
OBJECTIVE: To depict the influence of discretionary actions exercised by frontline professionals and organizations on the implementation of diverse modalities of access to specialized dental care within the Care Network for Persons with Disabilities. METHODS: A case study conducted in two Brazilian health regions characterized by distinct means of access to specialized dental care employing documentary analysis and interviews with key stakeholders across the period spanning from July to December 2019. RESULTS: In the referenced access region, there was a notable centrality of Primary Health Care (PHC) in caregiving, wherein planning and assessment were integral components of institutional routines. Where spontaneous demand scheduling was accepted, sporadic exchanges of information were evident between PHC units and specialized facilities. The coordination role in caregiving was not vested in PHC teams, and activities such as planning and assessment were not assimilated into organizational routines. CONCLUSIONS: The implementation of policies for specialized dental care for persons with disabilities relied on the coordination furnished by PHC and the orchestration of planning and assessment endeavors aimed at establishing an integrated care network. This implementation proved subject to the discretionary authority of frontline professionals and organizations, highlighting the significant role of relational and institutional environments in the context of public policy implementation within a decentralized and regionalized healthcare system. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-09-29 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/219186 10.11606/s1518-8787.2023057005318 |
url |
https://www.revistas.usp.br/rsp/article/view/219186 |
identifier_str_mv |
10.11606/s1518-8787.2023057005318 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/219186/200109 https://www.revistas.usp.br/rsp/article/view/219186/200108 https://www.revistas.usp.br/rsp/article/view/219186/200107 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf text/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 57 No. 1 (2023); 74 Revista de Saúde Pública; Vol. 57 Núm. 1 (2023); 74 Revista de Saúde Pública; v. 57 n. 1 (2023); 74 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221804034260992 |