Urgent and emergency care networks in Brazil: an integrative review (original) (raw)
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Public health, 2017
Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). Cross-sectional ecological study. Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs). For analytical purposes, we considered four specialties when examining the proxies of emergency care capability: adult, pediatrics, neonatal, and obstetric. We analyzed the spatial distribution of hospitals, identifying municipalities that rely exclusively on SHs and the distance of these cities from HCCs. More than 14 and 30 million people were at least 120 km away from HCCs with an adult intensive care unit (ICU) and pediatric ICU, respectively. For neonatal care distributio...
Integration between Primary Health Care and Emergency Services in Brazil: Barriers and Facilitators
International Journal of Integrated Care, 2018
Introduction: Characteristics of primary health care and emergency services may hamper their integration and, therefore, reduce the quality of care and the effectiveness of health systems. This study aims to identify and analyse policy, structural and organizational aspects of healthcare services that may affect the integration between primary health and emergency care networks. Theory and Methods: We conducted a qualitative research study based on grounded theory that included: (1) interviews with 30 health care leaders; and (2) documental analysis of the summaries of Regional Interagency Committee meetings from two regions in the state of Sao Paulo, Brazil. Results: The integration between primary health and emergency care network is inefficient. The barriers that contributed to this situation are as follows: (1) policy: the municipal health department is responsible for providing primary health care and the regional health department provides emergency care, but there is a lack of space for the integration of services; (2) structural: distinct criteria for planning mechanisms; and (3) organizational: ineffective point of interaction between different levels of the health system. Conclusions and discussion: Our findings have implications for health management and planning in low-and middle-income countries (LMICs) with suggestions for interventions for overcoming the aforementioned barriers.
Healthcare networks: trends of knowledge development in Brazil
Escola Anna Nery, 2019
Objective: To analyze the trend of scientific production about Healthcare Networks in thesis and dissertations in Brazil. Methods: documental, descriptive and exploratory study, with a quantitative approach, on the published between 2013 and 2016. The data collection was based on the catalog of theses and dissertations of Brazilian Personnel Improvement Coordination of Superior Level, during January 2018. Results: The 190 papers founded were distributed in four main classes: Integrated Healthcare Networks Management; Thematic health networks; Primary Healthcare as network Ordinator; and Professional education in healthcare networks. Conclusion: It is trend in the scientific knowledge production the study of Primary Healthcare as the ordinator of network and its interface with the other levels, the professional education in healthcare networks, the continuing education in health, focused on the healthcare networks management.
Emergency and Urgent Health Care Network on scene: contingencies and production of care
Saúde em Debate
This study aims to analyze the possible transformations in health care management and production processes, in the context of practice, based on the Emergency and Urgent Health Care Network (RUE) policy. The research has a qualitative character and is characterized as a case study. Interviews were conducted with 16 health service managers in four municipalities of different population sizes. The material was analyzed with reference to the context of the Public Policy Cycle Approach practice. It is observed that the RUE is not recognized as a public policy, although some of its elements are identified, such as the implementation of Emergency Care Units, protocols, risk classification, new care technologies, regulatory arrangements, and lines of care. Looking at the ‘RUE on scene’ mainly points to three issues: the relationship between primary care and emergency doors in meeting spontaneous demand; the medical regulation of Mobile Emergency Care Service (SAMU), as a promoter of access...
The current scenario of emergency care policies in Brazil
BMC Health Services Research, 2013
Background: The regulation of emergency care has featured prominently in Brazil's federal health agenda since the 2000s. The aim of this study was to review up to the present day the implementation of the National Emergency Care Policy.
The process of implementation of emergency care units in Brazil
Revista de saude publica, 2017
To analyze the process of implementation of emergency care units in Brazil. We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has ...
R The current scenario of emergency care policies in Brazil
Background: The regulation of emergency care has featured prominently in Brazil's federal health agenda since the 2000s. The aim of this study was to review up to the present day the implementation of the National Emergency Care Policy.
Primary Health Care: The Coordinator of the Care Integration in the Emergency and Urgency Network
Reme Revista Mineira de Enfermagem
Primary health care (PHC) is considered the main gateway to the health care network; however, there are difficulties to achieve it as such. Therefore, the objective of this study is to analyze the integration between the health unit and the emergency care unit (ECU-"Unidade de Pronto-atendimento", in Portuguese), with the PHC as an Emergency and Urgency Network (EUN) coordinator. It is qualitative, descriptive and exploratory research. During the data collection, 49 interviews were conducted with physicians, nurses and health managers between February and June 2015 in a capital city in the southern region of Brazil. From the data processing to the textual analysis performed by the IRAMUTEQ software, four classes emerged: formal and informal communication in the health organization; population access to health services; integration between HU and ECU; HU and ECU roles in the health care network. The research showed that the care integration between PHC and ECU is fragile and disjointed with the other services that make up the health care network, boosted by the lack of definition of the attributions of each EUN component by system managers and healthcare professionals, as well as the overlapping of roles between the HU and ECU.
Revista da Associação Médica Brasileira, 2017
Summary Introduction: The Regulatory Complex is the structure that operationalizes actions for making resources available to meet the needs of urgent and emergency care in the municipality of São Paulo. In the case of urgent care, needs are immediate and associated with high morbidity and mortality. Objective: To identify the most frequently requested resources, the resolution capacity and the mortality rate associated with the unavailability of a certain resource. Method: Our study was based on data from medical bulletins issued by the Urgent and Emergency Regulation Center (CRUE) in the city of São Paulo from 2009 to 2013. Results: 91,823 requests were made over the five years of the study (2009 to 2013). Neurosurgery requests were the most frequent in all years (4,828, 5,159, 4,251, 5,008 and 4,394, respectively), followed by computed tomography (CT) scans, adult intensive care unit (ICU) beds, cardiac catheterization, and pediatric ICU beds. On average, requests for neurosurgery...
2010
Demand for the Emergency Department (ED) has increased, making the organization of work difficult. This quantitative, descriptive and documental study identifies and analyzes the characteristics of clinical care in the ED of a General Hospital in Ribeirão Preto, SP, in 2007, according to organizational variables. The study population included all clinical care consultations registered in the Hospital Management Information System. Data were analyzed through descriptive statistics and discussed considering the theoretical framework of the Single Health System (SUS). A total of 5,285 consultations were registered in the period, which were more frequent in patients from the city itself, in January (10%), on Mondays (16%), from 12pm to 12am (67.1%). The main reason for discharge from the unit was hospitalization (63.8%) and the predominant length of stay in the unit was less than six hours (39.8%). The results support the management of human resources, materials and equipment, indicating the desirability of reorganizing emergency care in the hospital.