Acesso à rede de atenção à saúde : o olhar de usuários e profissionais de saúde a partir de um serviço hospitalar de urgência

• Ano de defesa: 2017
• Autor(a) principal: Rabello, Adriana Esteves
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Mestrado em Saúde Coletiva; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Saúde Coletiva
• Palavras-chave em Português: Health services accessibility; User embracement; Delivery of health care; Acolhimento; Assistência à saúde; Serviços de saúde; Acesso aos serviços de saúde; Assistência hospitalar; Saúde Coletiva; 614
• Link de acesso: http://repositorio.ufes.br/handle/10/10107

The primare care and emergency care policies in recent years was the strengthening of basic services, the establishment of an integrated services network and the qualification of emergency services, in order to increase the user access of health services. In this context, this study investigated the process of Urgency and Emergency Attention Network implementation in the state of Espírito Santo, based on the verification of the profile demand in an urgency and emergency hospital service and the analysis of the seeking and use process of the urgency and emergency services, from the perspective of professionals and users of the reception service and risk classification. It was theoretically based on Rovere's network concepts, and Frenk's access dimensions. It is a descriptive-exploratory research, using secondary quantitative data and qualitative data. Qualitative data were obtained from semi-structured interviews and field diary reports. For the qualitative analysis, the Bardin thematic analysis was used. The results indicated that the main demand was for low complexity users according to the Manchester protocol. In addition, the returns accounted for a large amount of classifications and medical appointments, indicating contradictions about the purpose of an emergency hospital. It also revealed the use of unofficial flowcharts within the protocol, suggesting the need for better adequation and training of professionals. Qualitative data revealed that the search and use process is crossed by institutional norms, tensions between users, professionals and relationships that are far from humanization and linkage. The risk classification was not very welcoming, relegating the function of embracement to social service, unveiling health practices similar to the classic triage model. In addition, the suffering of the workers against the user was evidenced. Revealed that the risk classification team's posture does not ensure recognition and accountability for the health needs of the users, and the appreciation of the desire for care was more evident in the speeches of social service workers. In conclusion, this research showed that the emergency care network still presents several fragilities and barriers in the achievement of health service accessibility, with fragmentation, poor integration and cooperation between services, also revealing a scenario with little resoluteness and humanization in face of the needs of access and care.