Full care in the health of elderly in primary care: the brazilian and the spanish systems / Atenção integral à saúde do idoso na atenção primária: os sistemas brasileiro e espanhol




The aim of this study was to analyse the understanding of managers, health professionals and elder people on health needs and full care in Primary Attention Health. This is an exploratory, qualitative study, which found analytical categories through the Discurso do Sujeito Coletivo (DSC), related to Taxonomy of Health Needs (Cecílio and Matsumoto, 2006) and they were analyzed based on Social Representation. The study setting was the Primary Health Care in the cities of Santos / São Paulo (Brazil) and LHospitalet de Lobregat (Spain). The number of interviewed people were 98, whose 68 (38 managers and health professionals, 30 elder) from Santos, and (17 managers and health professionals, 13 elder) from LHospitalet de Lobregat. Data collection was performed between August 2007 and March 2008 (Santos) and between September 2008 and May 2009 (LHospitalet de Lobregat). The categories related to the Taxonomy of the DSC were "needs of good conditions of life": global attention, social development and family support, intersectoral and quality of life; "guaranteed access to all technologies that improve and prolong life" health rights, home care, access to technology in health care for elder people, access to all levels of care and prevention and health promotion; "needs of autonomy and self-care in choosing the way of living life": autonomy promotion and independence of elder and health education; "need of a link with a professional or a team": host and accountability. The results of these two realities pointed out that, for managers, the management approach should focus the attention on user assistance; improve coordination between levels of care; have trained professionals to avoid duplication of actions and recognize that these actions must include intersectorality for elder social support on their needs. Health professionals believe that the assistance is provided with quality, but to provide assistance for this group increasingly dependent and with chronic illnesses-degenerative, it is necessary more trained professionals; the health services should be more accessible from primary to tertiary level of care. To elder people, the information about their health is provided in an understandable way, but when they need information, as well as the access to the network services, the information is complex and confusing; they prefer to use the emergency care as an alternative; they also realize that some professionals demonstrate commitment, responsibility, competence and empathy, as others have no interest in "listen" to their complaints; they have awareness of their rights and are willing to participate in decisions that affect their health. We conclude that, in Santos, the services are organized to primarily serve the elders in Primary Health Care through the Programa Saúde da Família in the same way that LHospitalet de Lobregat. However, the health system in Spain is better prepared to serve the elders with chronic, degenerative diseases and dependence, because it is a country with a great number of elder people


family health primary health care cuidados integrais de saúde saúde da família elder full health care health care for the elder idosos cuidados primários de saúde serviços de saúde para idosos

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