Eixos e a Reforma dos Cuidados em Atenção Primária em Saúde (RCAPS) na cidade do Rio de Janeiro, Brasil

Abstract

During the period of 1990-2000, Rio de Janeiro was characterized by a limited supply of public and universal primary care services. In 2008, family health team coverage corresponded to 3.5% of the population, the lowest among capital cities. At the end of 2013, coverage reached more than 40% of Rio residents with teams comprised of doctors, nurses, practical nurses, community health agents, and health surveillance agents, in addition to oral health teams. This article describes and analyzes the main components of the Reform in Primary Health Care (RCAPS) implemented since 2009, focusing on three lines of action: administrative reform, organizational model, and model of care. A new organizational chart of the Municipal Health Secretary and a legal framework for a new results-based model were created. As for the model of care, the standardization of procedures and health activities for all units and the monthly assessment of clinical indicators of results of implanted electronic medical records were created. Experience has shown the feasibility of RCAPS, pointing to new challenges that will allow consolidation of the expansion of access, training of human resources, health communication, and a shift to a managerial results-driven model.

Unidades de Saúde Familiar e Clínicas da Família – essência e semelhanças

“…Nas equipes com dimensão e diversidade humana e profissional adequadas, com personalidade e nome próprios, onde existe sentimento de pertença, sentido de missão, objetivos específicos partilhados e perceção dos resultados atingidos, têm sido registados melhores resultados de saúde 16,[18][19][20] . Cada equipe tende a funcionar como uma "pessoa" que tem um claro e forte sentido de vida, que lhe advém de produzir valor para os outros.…”

“…São múltiplos os fatores que influenciam a motivação dos profissionais e existe evidência de saltos qualitativos e quantitativos descritos em diversos estudos [14][15][16][18][19][20] .…”

Atenção Primária à Saúde na coordenação das Redes de Atenção à Saúde no Rio de Janeiro, Brasil, e na região de Lisboa, Portugal

“…In RJ, the Network of Observatory Stations for Information and Communication Technologies in Health Systems and Services (OTICS) was created, a complementary axis to the expansion of the PHC, to provide physical and technological support for the qualification of professionals and for the evaluation of PHC indicators. According to the selected studies, which focused precisely on electronic health records, they emphasize that their introduction contributed to the elimination of "duplicate" registrations, as well as the reduction of waiting time for consultations, examinations and procedures, further contributing for the quality of the records and for a better access for the population 16 .…”

O uso do Primary Care Assessment Tool (PCAT): uma revisão integrativa e proposta de atualização

“…Regarding the general score, which includes the already described family and community orientation attributes, we observed a similar range of values: 3.66 in Ilhéus and 7.01 in Rio de Janeiro. The result may be related to the choice made by the municipality of Rio de Janeiro of scaling-up expansion of PHC services, which increased population coverage from 3.5% in 2008 to 70% in 2016 22 . It also established a family and community medicine residency program, which increased municipal PHC capacity 17,23 .…”