Secondary Health Care: best practices in the health services network

Abstract

Objective: to understand the organization of health practices, based on the interactions at the secondary care level, and to analyze how the actions and services at this level of care contribute to the development of best practice in health. Method: a qualitative approach, based in Grounded Theory. Data was obtained from individual interviews, with managers, health care professionals and health service users making up the sample group representing the secondary level of healthcare. The theoretical model was formulated based on four categories, analyzed based in the elements of the network modeling of health care theoretical framework. Results: The organization of health practices at a secondary level is in the process of consolidation and is contributing to the development of best practices in the locale studied. Conclusion: The broadening of access to consultations and specialized procedures, and the articulation of the network's points, are aspects of this level of care which are considered essential for care which is effective and integral. This study contributes to the analysis of health practices from the perspective of network modeling, based on the interactions between secondary care and the health system's other health facilities, which are shown as going through a process of consolidation in the locale studied. La atención secundaria en salud: mejores prácticas en la red de serviciosObjetivo: Comprender la organización de las prácticas de salud, desde las interacciones en el nivel de la atención secundaria y analizar cómo las acciones y servicios en este nivel han contribuido al desarrollo de mejores prácticas en salud. Método: Enfoque cualitativo, apoyado en la Teoría Fundamentada en los Datos. Se realizaron entrevistas con gestores, profesionales de salud y usuarios, que conforman el grupo muestral de la atención secundaria. Resultados:Se formuló el modelo desde cuatro categorías, analizadas con base en los elementos del modelado de red de atención a la salud. La organización de las prácticas en el nivel secundario se encuentra en proceso de consolidación y ha contribuido al desarrollo de mejores prácticas en salud en el local estudiado. Conclusión: La ampliación del acceso a consultas y procedimientos especializados y la articulación de puntos de la red son aspectos de este nivel considerados imprescindibles para la integralidad del cuidado. Este estudio contribuye para el análisis de las prácticas en salud en la perspectiva del modelado de red, desde las interacciones de la atención secundaria y los otros puntos del sistema de salud, que se presentan en proceso de consolidación en el contexto estudiado.

Chronic disease in childhood and adolescence: continuity of care in the Health Care Network

“…This perspective strengthens the HCN by developing a proactive and direct approach and reducing the demands in other levels of care (21) . However, the FHS teams feel overwhelmed by the demand for care in cases of acute conditions because these cases exceed the number of professionals and go beyond the action planning, which is based on the singularities of each population (6) .…”

“…The establishment of flow and counter flow in HCN prepares the services for users, facilitates access to care, ensures the continuity of care (21) , and contributes to the families' sense of satisfaction and security by acknowledging the timely solution of their claims and preventing physical and emotional stress due to the constant search for care services.…”

“…The regulatory system of the HCN does not respond effectively to the demands of the population, generating significant absenteeism (21) and long waiting periods for consultations. This situation occurs in cases in which the network disregards the users' choice of geographical area for consultations with specialists and examinations because these regions are often distant from their homes, limiting access to services.…”

The construction of permanent education in the process of health work in the state of Minas Gerais, Brazil

“…From the managerial point of view, this improvement translates as a reduction in referrals to specialized services and hospitalization, increasing the service's resoluteness. 23 By realizing the benefits of EPS for the population, professionals have the opportunity to improve health practice. It is related to the insertion of problematization in everyday life.…”

Desafios Da Referência E Contrarreferência Na Atenção Em Saúde Na Perspectiva Dos Trabalhadores

“…Estudos foram realizados com a APS (8) e atenção secundária (9) . No entanto, não foram identificadas pesquisas sobre a articulação da APS e a Atenção Terciária, as quais auxiliariam a análise dos processos de referência e contrarreferência entre os profissionais da saúde.…”