Os consórcios intermunicipais de saúde do Paraná e a assistência médica especializada

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

Inter-municipal Health Consortia (IHC) appeared in the scope of the Brazilian Public Health System in the late 1980?s and established in the 90?s. The municipal administrators adhered to this new policy of administrating health care in order to unite forces to optimize and improve the offer of mainly specialized health care. The Inter-municipal Health Consortia need be implemented in a planned context ?adequate basic health care and an efficient reference and counter-reference system ? to avoid that the demand for specialized medical consults and assisted diagnostic and therapeutic exams increase quickly without any order. Starting from this conception this research aims at analyzing the IHC of Paraná concentrating on specialized medical assistance. Twenty Consortiums that had already been implanted in Paraná in 2000 participated in this research, one of which was focused on in a more detailed way. Data were collected in three stages: through reports about the Consortia of Paraná, done by the State Board of Health; through questionnaires sent to twenty Consortia; and, with regard to the Consortium focused on, directly from its own files and documents. The data were transferred to Epi Info 6.04b software and Micosoft Excel worksheets and analyzed in two stages. Firstly the data from all IHC?s of Paraná are presented and discussed. Then the data of the selected IHC are presented and discussed. Out of 399 municipalities of Paraná 81,5% belong to IHC and totalize a population of 5.378.636 habitants, corresponding to 56,3% of the State population (9.558.454). Specialists are assigned to a consortium by municipalities, the State and/or the Union, but are also hired on behalf of the consortium itself. Consequently, there is an increase of specialized consults, although controversy has been created about the public/private relation. With regard to the focussed Consortium, failure was detected in the reference/counter-reference system. Further more, difficulties in adjusting CIS programmed offer, consorted municipalities and population needs were observed. Out of all patients awaiting, 35,7% awaited for ophthalmology and 30,9% for neurology. Actions should be taken to improve the reference/counter-reference system. Inter-municipal Health Consortia are a strategy still under construction that will probably suffer changes through the latest Health Assistance Operational Norm, but that tends to establish in the National Health System as a possible way to increase and organize specialized medical assistance when used with criteria and planning.

ASSUNTO(S)

consórcios intermunicipais de saúde - paraná saúde - planejamento sistema Único de saúde saúde - planejamento saúde pública consórcios intermunicipais de saúde - paraná public health system saúde pública health planning public health system inter-municipal health consortia (ihc) health planning public health inter-municipal health consortia (ihc) public health

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