Regulação da atenção no cenário da regionalização da saúde no estado do Ceará

Abstract

Health regulation comprises a considerable number of activities, instruments and strategies, considering its set of actions, services and programs that include both individual and collective care and require attention at different out patient and hospital health care points. It is structured around three axes: regulation of health systems; regulation of health care; regulation of Access to assistance or assistance regulation. Therefore, this study aimed to analyze the regulation of care in the scenario of Regionalization in the State of Ceará from the perspectives of managers. This is a qualitative evaluation research, with managers Who work directly and indirectly with the regulation of Access at the regional level. The research Field comprised three of the five health regions in the state of Ceará: Fortaleza region, Sobral region and Cariri region. Information from primary and secondary sources was used, with 10 individual in-depth interviews being carried out. Thematic analysis was used as a theoretical methodological framework, consisting of the following steps: 1) pre-analysis, 2) Exploration of the material, 3) Interpretation. From the material analyzed, the following categories emerged: new model of regionalized regulation; expansion of the offer; logistics and support system. The study was approved by the committee of the Federal University of Ceará (UFC) with opinion 5,380,178. The results showed that the regionalization process in Ceará does not create a paradigmatic change in the modus operandi of the management of access flows to health services, inducing the decentralization of the Regulation Centers (CRER's), shifting the management of regulation of access to health units under state and municipal management, within the health region, which presuppose greater Access to the population itself at the regional level. It is concluded that the perspective of regionalization as a strategy in concrete access has proven to be a viable and coherent path, especially when it comes to decentralizing health services in a larger territorial space and concentrating resources necessary for care management. However, this organizational arrangement creates other demands for regionalized care networks, especially in hospital care, where resources are scarce and Access regulation is essential.