Management of basic health units in municipalities of different size: profile and management instruments

Abstract

RESUMEnObjetivo: Identificar las características de los gerentes, el uso de instrumentos de gestión en la atención básica y analizar las diferencias de esos aspectos en municipios de diferentes portes poblacionales. Méto-do: Estudio del tipo transversal descriptivo, realizado en 108 unidades básicas de salud de 21 municipios del norte de Paraná, Brasil. Se recogieron los datos por cuestionario semiestructurado en el segundo semestre de 2010. Resultados: La mayoría de los gerentes era del sexo femenino, enfermeras y postgraduadas. En los pequeños municipios eran más jóvenes, cobraban sueldos más bajos y tenían menos experiencia. El empleo de instrumentos de gestión fue expresivo tanto para la organización como para la gestión laboral, sin embargo fueron menos utilizados en los pequeños municipios. Conclusión: Se constató comprometimiento de la gestión laboral y se recomienda el planteamiento de políticas orientadoras en el marco federal y estatal en apoyo a los pequeños municipios. AbStRActObjective: To identify the characteristics of managers and their use of management instruments in primary care and to analyze differences in these features among municipalities of different sizes. Method: The present cross-sectional descriptive study was conducted at 108 basic health units from 21 municipalities in northern Paraná, Brazil. The data were collected using a semi-structured questionnaire during the second half of 2010. Results: Most managers had graduate degrees and were female and nurses. The managers from the small municipalities were younger, their payment was lower, and they had less work experience. The use of management instruments was expressive for both the organization and work management; however, the instruments were used less in the small municipalities. Conclusion: The managers were committed to their role; it is recommended that policies and guidance should be formulated at the federal and state levels to support small municipalities.

Perfil dos gerentes da Atenção Primária: uma revisão integrativa

“…Processo que ocorre através de emissão de juízo de valor, resultando em uma atuação qualificada, eficiente, com gestores motivados e criativos, demonstrando, assim, a importância da inserção da avaliação no processo gerencial 7,8,10,18 .…”

“…Dentre outras funções exercidas estão: serviços assistenciais, responsabilidade técnica da unidade, coordenação dos programas, alimentação de sistemas de informação e responsabilidade pela ouvidoria da saúde 10,12,[15][16]18 .…”

Gestão na atenção primária: implicações nas cargas de trabalho de gestores

“…Group 3 describes aspects related to labor instruments, understood in a broad sense including: deficits in the physical area, equipment, materials and information systems (18,24,27,38,41-42,44-46-50,54,57,61-62,64-66) , problems in the geographical location of local health units (65,71) , with emphasis on the deficits in financing and also on efficiency in the application of resources (18)(19)24,(27)(28)30,(35)(36)40,50,65,(71)(72)(73) . Rev Gaúcha Enferm.…”

Expansion of the interprofessional clinical practice of Primary Care nurses

“…The national literature on the nursing work process also highlights its double dimension: management and care, present both in primary and specialized care (13)(14) . The changes in the practices of PC nurses, in the last two decades, with the implementation of ESF, indicate the expansion of direct care to users, families and community, while keeping their managerial work; however, both are guided by the traditional care and management models, in which the Taylorist/post-Fordist and biomedical approach prevail (14) .…”