0329/2015 - Descentralização da gestão: caminho percorrido, nós críticos e perspectivas Health management decentralization: road traveled, critical nodes and perspectives
Objetivou-se analisar a descentralização da gestão em saúde para o ente municipal e suas implicações para o acesso e a atenção integral ao usuário. Por meio de “scoping review” encontrou-se 1.902 referências. Após submetidas aos critérios de inclusão e exclusão, por juízes, selecionou-se e mapeou-se 27 artigos para pesquisa. Do mapeamento resultaram os temas: o que foi possível consolidar com o processo; nós críticos para trilhar o caminho e perspectivas para a descentralização. Verificou-se: ampliação do acesso à atenção básica com aumento do número de profissionais e de equipes de Saúde da Família; planejamento, avaliação e intersetorialidade foram tidos como problemáticos; instrumentos de planejamento e gestão são limitados, e os municípios encontram dificuldades na referência para a atenção de média e alta complexidade. O financiamento ainda é uma barreira para o avanço da descentralização, poucos estudos analisaram a garantia de acesso para média e alta complexidade e estudos que retratem a realidade dos municípios de pequeno porte são necessários. Vários desafios foram apontados como a necessidade de efetivação do processo de regionalização, gestão compartilhada e de rede interfederativa que garanta acesso e atenção integral a saúde.
Palavras-chave:
Descentralização
Gestão em Saúde
Sistema Único de Saúde
Acesso Universal aos Serviços de Saúde
Atenção Integral a Saúde
Abstract:
The objective was to analyze the health management decentralization at the cities scope and its implications for access and comprehensive care to the user. Through "scoping review", 1.902 references were found. After subjected to the criteria of inclusion and exclusion, by judges, were selected and mapped 27 articles for research. The mapping of the issues resulted: what was possible to consolidate with the process; critical nodes for the path and some considerations about prospects of decentralization. It was found: increased access to primary care through increasing the number of professionals and family health teams; planning, evaluation and intersectoral were seen as problematic; instruments of planning and management are limited, and cities face difficulties in reference to the attention of medium and high complexity. Financing is still a barrier to the advancement of decentralization, few studies have analyzed the guarantee of access to medium and high complexity and studies that portray the reality of small cities are needed. Several challenges were identified as the need for realization of the regionalization process, shared management and interfederativa network that ensures access and comprehensive health care.
Keywords:
Decentralization
Health Management
Unified Health System
Universal Access to Health Care Services
Comprehensive Health Care
Health management decentralization: road traveled, critical nodes and perspectives
Resumo (abstract):
The objective was to analyze the health management decentralization at the cities scope and its implications for access and comprehensive care to the user. Through "scoping review", 1.902 references were found. After subjected to the criteria of inclusion and exclusion, by judges, were selected and mapped 27 articles for research. The mapping of the issues resulted: what was possible to consolidate with the process; critical nodes for the path and some considerations about prospects of decentralization. It was found: increased access to primary care through increasing the number of professionals and family health teams; planning, evaluation and intersectoral were seen as problematic; instruments of planning and management are limited, and cities face difficulties in reference to the attention of medium and high complexity. Financing is still a barrier to the advancement of decentralization, few studies have analyzed the guarantee of access to medium and high complexity and studies that portray the reality of small cities are needed. Several challenges were identified as the need for realization of the regionalization process, shared management and interfederativa network that ensures access and comprehensive health care.
Palavras-chave (keywords):
Decentralization
Health Management
Unified Health System
Universal Access to Health Care Services
Comprehensive Health Care
Pinafo, E., Carvalho, B.G, Nunes, E. F. P. A.. Descentralização da gestão: caminho percorrido, nós críticos e perspectivas. Cien Saude Colet [periódico na internet] (2015/nov). [Citado em 24/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/descentralizacao-da-gestao-caminho-percorrido-nos-criticos-e-perspectivas/15402?id=15402&id=15402
