Cartography of Specialized Health Care in SUS: Formulation, Training and Management of Care in Networks

• Grant number: 23/10250-6
• Support Opportunities: Research Grants - Research in Public Policies
• Start date: March 01, 2024
• End date: February 29, 2028
• Field of knowledge: Health Sciences - Collective Health
• Principal Investigator: Ademar Arthur Chioro dos Reis
• Grantee: Ademar Arthur Chioro dos Reis
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
• Associated researchers: Alcindo Antônio Ferla ; Amanda Seraphico Carvalho Pereira da Silva ; Ana Lucia Pereira ; Andre Luis Bonifacio de Carvalho ; Aparecida Linhares Pimenta ; Ardigo Martino ; Aristides Vitorino de Oliveira Neto ; Arthur de Almeida Medeiros ; Carlos Amilcar Salgado ; Carlos Roberto de Castro e Silva ; Clarisvan do Couto Gonçalves ; CRISTIAN FABIANO GUIMARAES ; Daniele Marie Guerra ; FERNANDO TURECK ; Flavia do Bonsucesso Teixeira ; Franciele Finfa da Silva ; GILIATE CARDOSO COELHO NETO ; Greice Herédia dos Santos Moura ; Heider Aurelio Pinto ; Helvécio Miranda Magalhães Júnior ; jorge harada ; José Santos Souza Santana ; Larissa Maria Bragagnolo ; Ligia Schiavon Duarte ; Lucas Cardoso dos Santos ; Luís Fernando Nogueira Tofani ; LUMENA ALMEIDA CASTRO FURTADO ; Marcelo Dayrell Vivas ; Maria Augusta Nicoli ; Mariana Alves Melo ; Mariana Arantes Nasser ; Mariana Prado Freire ; Marilia Cristina Prado Louvison ; Nicanor Rodrigues da Silva Pinto ; NILTON PEREIRA JÚNIOR ; Olívia Félix Bizetto ; Rodrigo Cariri Chalegre de Almeida ; Rosemarie Andreazza ; Samara Kielmann Almeida dos Reis ; Sandra Maria Spedo ; Sônia Barros ; Sônia Maria Lemos ; Suzana Cristina Silva Ribeiro ; Thiago Marchi Sacoman
• Associated scholarship(s): 24/18681-9 - SOCIAL MOVEMENTS AND SPECIALIZED ATTENTION IN SUS: CO-MANAGEMENT CARE ON NETWORKS, BP.TT; 24/10739-8 - Analysis of Specialized Care in Brazil: challenges and prospects in the health regions, BP.TT; 24/06457-7 - Cartography of Specialized Care in the System Unified Health System (SUS): formulation, training and management in care networks, BP.PD; + associated scholarships 24/07130-1 - Mapping Specialized Care in São Paulo: building care management networks in health regions, BP.TT; 24/06468-9 - Cartography of Specialized Care in the System Unified Health System (SUS): formulation, training and management in care networks, BP.TT; 24/06504-5 - Proposal for a Specialized Care Observatory in the SUS for the formulation of the Specialized Care Policy in Health Regions, BP.TT - associated scholarships

Abstract

In Brazil, specialized care (AE) is one of the main "critical nodes" of the Unified Health System (SUS). The quest to guarantee the universal right to health, in an equitable and comprehensive manner, necessarily involves improving access and care produced in different health services, particularly specialized ones. The current EC policy was constituted in a fragmented way and cannot be considered a structured policy. It is imperative for managers and researchers committed to the SUS to properly scale the problem to understand the barriers that generate the production of queues for surgeries, consultations, exams and procedures. It is also necessary to know the different typologies, models and technological arrangements of care produced in different health services, considering the regional diversities and inequalities in the Brazilian context. Thus, the objective of the investigation is to support the formulation and implementation of the Specialized Health Care Policy in the SUS. The proposed study does not end with the investigation of the policy, proposing to contribute with SUS managers at national, state and municipal levels in the process of critical analysis and reformulation of the policy itself. To this end, a qualitative, multicenter study will be carried out, to be developed in partnership with the team of the Secretariat of Specialized Care (SAES) of the Ministry of Health (MS), in close articulation with the Term of Decentralized Execution (TED) signed between the Ministry of Health and the Federal University of São Paulo (Unifesp). Based on a multidimensional situational diagnosis carried out in all Brazilian states, the investigation will be deepened in the five regions of the country through in-depth analysis in 09 Federated Units and in the Federal District. In each state, two to three health regions will be studied, indicated by SAES-MS with the following selection criteria: a) health region in the capital and inland areas; b) presence of University Hospital managed by the Brazilian Company of Hospital Services (EBSERH). Four devices will be used for the production and analysis of information: 1. Shared regional seminars with the actors involved for the restitution of the findings and production of other visibilities, based on the results of the situational diagnoses produced within the scope of the TED; 2. Production of a virtual platform, linked to UNIFESP and SAES-MS, for collecting information and constituting a real-time information network for the Interfederative Forum of AE within the scope of MS; 3. Mapping of successful experiences in specialized care in the country and in other national health systems through the following procedures: a) Open interviews with the service teams responsible for innovative arrangements in the field of EC management, care and governance, b) Observation and conducting open interviews with users in the waiting rooms of the listed services, c) Literature review on arrangements and models of organization of the EC, d) Technical visits to learn about experiences from other countries in the organization of the EC network; 4. Training of network care management learning advisors and managers: training-intervention processes with managers, regulatory professionals and health service managers in 19 health regions in the logic of Permanent Education, aiming at the construction of strategies for SUS management and governance for the production, evaluation and monitoring of regional Specialized Care networks. It is expected to constitute a PNAES planned and implemented through strengthened regional governance, financed through models that induce the intended transformations, based on matricial arrangements, regulation, telehealth and permanent education strategies that guarantee the continuity of care in regional networks, integrated in a network primary care and hospital care. (AU)