Practices and challenges on coordinating the Brazilian Unified Health System

• Published in: Revista de saúde pública 2020-01, Vol.54, p.25-25
• Main Authors: Bastos, Luzia Beatriz Rodrigues, Barbosa, Maria Alves, Rosso, Claci Fátima Weirich, Oliveira, Lizete Malagoni de Almeida Cavalcante, Ferreira, Ilma Pastana, Bastos, Diniz Antonio de Sena, Paiva, Ana Cláudia Jaime de, Santos, Alex de Assis Santos Dos
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Brazil; Case Managers; Health Personnel; Health Policy & Services; Health Services Accessibility - organization & administration; Health Services Needs and Demand; Humans; Institutional Management Teams; National Health Programs - organization & administration; Original; Patient Care Team, organization & administration; Personnel Management; Primary Health Care - organization & administration; Qualitative Research; Unified Health System, legislation & jurisprudence
• ISSN: 0034-8910; 1518-8787; 1518-8787
• DOI: 10.11606/S1518-8787.2020054001512

To analyze the obstacles and challenges faced by managers and coordination professionals in their practices in municipal coordinating centers. An exploratory descriptive study with a qualitative focus, applied in 40 managers and coordination professionals, from September 2017 to November 2018, with semi-structured interviews, resulting in two categories of analysis: limiting factors and factors that facilitate the management and operationalization of the Brazilian Unified Health System (SUS) coordinating sector. Analyzing the statements, we found evidence of the following limiting factors: failure in the criteria of referral, unavailability of beds, high demand, systemic difficulties in relation to the coordinating system, procedures of difficult scheduling and execution, increased repressed demand for elective procedures and difficulties in the flow of information between primary care and coordination. In the category of facilitating factors, the most significant possibilities were: expansion of the capability to know the user's reality, improvement in primary care and increase in health financial resources, health training and education and restructuring, in addition to reorganizing internal coordinating procedures. The limiting factors of coordination show the need to promote actions that offer all SUS users full access to health services.