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Atención especializada en regiones de salud: desafíos para garantizar el cuidado integral en Brasil
Specialized care in health regions: challenges to ensure comprehensive health care in Brazil
DOI:
https://doi.org/10.15446/rsap.v20n3.61392Palabras clave:
Atención integral de salud, regionalización, accesibilidad a los servicios de salud (es)Comprehensive health care, regional health planning, health services accessibility (en)
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Objetivos Analizar aspectos de la provisión de asistencia especializada en el contexto de incipiente integración regional y barreras para la oferta de atención integral en salud.
Materiales y Métodos Estudios de caso en tres municipios sedes de regiones de salud del estado de Bahía, Brasil, con realización de 31 entrevistas semiestructuradas con gestores de salud, encuestas a 201 médicos y enfermeros de EqSF y 1 590 usuarios.
Resultados Hubo convergencia en cuanto a la escasez de retaguardia terapéutica, considerando las limitaciones que sufre el planeamiento local por el bajo financiamiento público y las dificultades para atraer especialistas. Un porcentaje expresivo de usuarios busca servicios especializados directamente en el sector privado.
Conclusiones La oferta de atención integral en salud enfrenta, además del desafío de fortalecer la APS en sus atributos esenciales, escasez de oferta en especialidades, fragmentación entre diferentes puntos de la red y desarticulación comunicacional entre niveles del sistema de salud.
Objective To analyze aspects of specialized health care provision in the context of incipient regional integration, as well as barriers to offering comprehensive health care.
Materials and Methods Case studies in tree municipal seats of health regions in the state of Bahia, Brazil. 31 semi-structured interviews were conducted with health managers and surveys were applied to 201 physicians and nurses of family health care teams and 1 590 users.
Results The participants agreed on the lack of the specialized health care, considering limitations in regional planning due to low public funding and difficulties to attract specialized physicians. A significant percentage of users seek specialized health care directly in private services.
Conclusions The provision of comprehensive health care faces not only the challenge of strengthening the essential characteristics of primary health care (PHC), but also the lack of specialists, the fragmentation between different points of the network and communicational disarticulation between levels of the health system.
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Derechos de autor 2018 Revista de Salud Pública
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