Avaliação da qualidade da atenção básica no município de Bauru: desafios para um processo de mudança
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Data
2011-03-01
Autores
Vasconcelos, Roseli d' Avila [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O Município de Bauru foi um dos pioneiros na valorização da Atenção Básica por implantar uma rede municipal de serviços, antecipando-se no início dos anos 80 ao processo de municipalização. Durante 15 anos essas inovações não tiveram sustentabilidade, havendo uma progressiva fragilização da rede de saúde. Em 2005, a gestão municipal criou condições político institucionais de reavaliação desse processo, assumindo o resgate da Atenção Básica como uma das prioridades do governo. O presente trabalho tem como objetivo avaliar a qualidade da Atenção Básica no município de Bauru, de 2005 a 2008 com foco na gerência e organização das ações de atenção à saúde. Trata-se de estudo transversal organizado na forma de uma pesquisa avaliativa estruturada. Uma primeira avaliação foi realizada ao final do primeiro ano da gestão, em 2006, por meio de um questionário piloto. O questionário final, denominado QuaIiAB, foi novamente aplicado em 2007 e 2008. Foi realizada também análise documental de relatórios de gestão e plano de ações, além do uso de informações de relatório sobre dados qualitativos colhidos em 2006. Foram avaliadas três dimensões da organização dos serviços: estrutura, assistência e gerência. Os resultados apontam evoluções positivas, e outras que necessitam de investimentos.Na evolução as unidades quanto à dimensão estrutura, existem dificuldades em relação à área física, equipamentos e falta de pessoal, os avanços foram em relação à aquisição de medicamentos, ampliação da coleta de exames clínico-laboratoriais. Na dimensão assistência, as evoluções foram na atenção programática para os adultos, crianças e gestantes; já as ações para demanda espontânea, adolescentes, idosos, usuários de álcool e mulheres em situação de violência ainda necessitam de investimentos. Na dimensão gerenciamento...
Bauru was one of the first cities to value Basic Care for implementing a municipal system of services, anticipating the very process of municipalization in the beginning of the 1980s. During fifteen years such innovations had no sustainability due to a progressive fragilization of the health system. In 2005, municipal government created institutional and political conditions to re-evaluate such process, taking the recovery of Basic Care in the city of Bauru as a government priority. The present study aims at evaluating the quality of Basic Care in the city of Bauru from 2005 to 2008, with a focus on the management and organization of actions of health care. It is characterized as a transversal study organized as a structured evaluative research. A first evaluation was conducted at the end of the first year of government, in 2006, by means of a pilot questionnaire. The final questionnaire, called QualiAB, was applied again in 2007 and 2008. A documental analysis of management reports and action plans was done, besides the use of information about qualitative data collected in 2006. Three dimensions of services organization were evaluated: structure, assistance and management. Results point positive evolutions as well as other elements in need of improvement. In terms of structure, there are difficulties related to physical area, equipment and lack of professionals. Advancements can be seen in the purchase of medication and in the increase of collection of laboratory tests. In terms of assistance, improvements rely on basic care to adults, children and pregnant women, while actions on spontaneous demand, adolescents, elderly, alcohol addicts and abused women need investments.In the realm of management, health units improved in terms of the diversity of trained professionals, technical and management growth of leaderships, relationship with central level and teams; however... (Complete abstract click electronic access below)
Bauru was one of the first cities to value Basic Care for implementing a municipal system of services, anticipating the very process of municipalization in the beginning of the 1980s. During fifteen years such innovations had no sustainability due to a progressive fragilization of the health system. In 2005, municipal government created institutional and political conditions to re-evaluate such process, taking the recovery of Basic Care in the city of Bauru as a government priority. The present study aims at evaluating the quality of Basic Care in the city of Bauru from 2005 to 2008, with a focus on the management and organization of actions of health care. It is characterized as a transversal study organized as a structured evaluative research. A first evaluation was conducted at the end of the first year of government, in 2006, by means of a pilot questionnaire. The final questionnaire, called QualiAB, was applied again in 2007 and 2008. A documental analysis of management reports and action plans was done, besides the use of information about qualitative data collected in 2006. Three dimensions of services organization were evaluated: structure, assistance and management. Results point positive evolutions as well as other elements in need of improvement. In terms of structure, there are difficulties related to physical area, equipment and lack of professionals. Advancements can be seen in the purchase of medication and in the increase of collection of laboratory tests. In terms of assistance, improvements rely on basic care to adults, children and pregnant women, while actions on spontaneous demand, adolescents, elderly, alcohol addicts and abused women need investments.In the realm of management, health units improved in terms of the diversity of trained professionals, technical and management growth of leaderships, relationship with central level and teams; however... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Saúde pública, Cuidados primários de saúde, Bauru (SP), Evaluation
Como citar
VASCONCELOS, Roseli d' Avila. Avaliação da qualidade da atenção básica no município de Bauru: desafios para um processo de mudança. 2011. 161 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2011.