Author:

• Gisele ODwyer - ODwyer, Gisele - odwyer@ensp.fiocruz.br - <odwyer@ensp.fiocruz.br> +

Co-author(s):

• Cristiani Vieira Machado - Machado, C. V. - Rio de Janeiro, RJ - ENSP/FIOCRUZ, DAPS - <cristiani@ensp.fiocruz.br, cristiani.vieira.machado@gmail.com>
ORCID: https://orcid.org/0000-0002-9577-0301
• Renan Paes Alves - Alves, Renan Paes - ENSP/FIOCRUZ, DAPS - <renavesp@gmail.com>
• Fernanda Gonçalves Salvador - Salvador, Fernanda Gonçalves - ENSP/FIOCRUZ, DAPS - <afernandasalvador@gmail.com>

Thematic Area:

Planejamento e Gestão em Saúde

Abstract:

A fundamental part of emergency care is mobile prehospital care. The objective of this study was to analyse the implementation of the Mobile Emergency Care Service (SAMU) in the state of Rio de Janeiro.
The methodology included documental analysis, visits to six SAMU Regulation Centres and semistructured interviews with 12 state and local managers from the emergency care area. Giddens‘ Structuration Theory was adopted as the framework for analysis.
Intergovernmental conflicts were observed between the state and municipalities and between different municipalities. Despite the lack of beds, the SAMU ambulance services in smaller inner state locations were more connected to the emergency care services than in the metropolitan regions. The steering committees were found to be somewhat latent and the state fragile in its role of funding, managing and monitoring the service. In conclusion, the SAMU implementation in the state has been characterised by political tensions and weak management and coordination. Consequently severe limitations persist in terms of links between the SAMU and other services and the regionalisation of emergency care in the state.

Keywords:

emergencies mobile emergency units public health policies

Content:

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