Reception: Strategic Point for User Access to the Unified Health System

Abstract

This study investigated to understand how user embracement of users with acute illness or chronic worsened works, which has no scheduled service (spontaneous demand) from the perspective of workers of the reception service of health centers in a municipality in the southern region of Brazil. Descriptive exploratory qualitative study conducted in ten health centers in a municipality of Santa Catarina, Brazil. In data collection 17 workers from the reception of these health services were interviewed between January and March 2014. Thematic content analysis was performed. The results showed that user access does not occur as recommended by the Ministry of Health, due to weaknesses in the work process. Therefore, it is necessary to reorganize the work process, considering the reception as a strategic point in order to qualify the access of users to the Unified Health System.

Embracement with risk classification: relationship of justice with the user

“…With this, a good communication between users and nurses should be extended to all multiprofessional team and it is necessary for an adequate assistance that meets the rights of users. The lack of information and embracement generates feelings of subordination and exclusion to users (24) who are subjected to a system that provides privileges to some to the detriment of others. According to the Honnethian perspective, practices that generate sensations of subordination or exclusion are considered unfair, since they substantially harm the autonomy of the subject (19) .…”

“…In this study, it was found, as explained in subcategory III, Contributions versus Conflicts, that, sometimes, emergencies become reference units for these users in search of health care, even in cases of low complexity. It should be emphasized that there is no specific "gateway" in health services; users need to have their needs met regardless of the care unit sought (24) . In addition, they must be received in a resolute and fair manner, taking into account the ethical principles of care.…”

“…One of the factors that affects the ethics of care is related to "undue reclassifications" performed by non-health professionals (24) , and prioritization of care based on knowledge or kinship with professionals working in the unit that generate a sense of injustice in the other users, who are disadvantaged, extending to nurses who have their RC disrespected. These attitudes are in line with what is advocated by the ACCR device, which aims to provide care according to the degree of health impairment and not the impersonal.…”

Nursing care practices for people with Chronic Noncommunicable Diseases

“…This may end up hampering the development of actions such as health promotion, disease prevention and home visits (2) . On the other hand, their care has the potential to improve the quality of care, since PHC professionals are familiar with their health history and have a relationship with the population of their territory (27) . Thus, it is necessary to organize the work process in order to integrate the programmatic and spontaneous actions, to program and to develop the activities of health promotion, prevention of diseases and, at the same time, to prioritize the solution of the most common problems, considering the responsibility of the resolution assistance to spontaneous demand (28) .…”

Perfil das vítimas de acidentes de trânsito encaminhados a uma unidade de pronto atendimento

“…Ainda que o serviço de saúde possibilite acesso direto do usuário à UPA, a ida do sujeito por meios próprios é complicada se analisarmos a importância do SAMU e do corpo de bombeiros em acolher os indivíduos no local do acidente e classificar o trauma segundo o risco e as suas vulnerabilidades. Estudo desenvolvido previamente 14 reforça o desafio do SUS no que se refere ao acesso do usuário, demonstrando haver muitas fragilidades na organização do processo de trabalho. Segundo o estudo em questão, o usuário ainda não entende as especificações e o papel de cada setor de saúde, e muitas vezes negligencia a importância da atenção primária perante a atenção terciária.…”