Assistência ao diabetes no Sistema Único de Saúde: análise do modelo atual

Abstract

O sistema de saúde nacional, impulsionado por contextos econômicos restritivos, passou por uma reestruturação organizacional na década de 1990, voltada à atenção primária. Apesar das reformas, a incidência de diabetes mellitus ainda atinge elevadas proporções. Devido à alta morbi-mortalidade, a prevenção dessa morbidade tem-se tornado foco atual, fazendo-se necessário o desenvolvimento de programas eficazes e viáveis ao Sistema Único de Saúde, tais como ênfase na prevenção primária, controle da incidência e complicações da doença. Para que isso ocorra, o modelo da atenção atual prestada ao paciente deve ser modificado, priorizando a atenção primária, com a substituição do modelo médico-hegemônico por uma equipe interdisciplinar, onde o farmacêutico, como membro da equipe, possa prover seus serviços, minimizando assim impactos sociais, humanísticos e econômicos que a doença acarreta para a sociedade. O objetivo da presente revisão foi abordar a temática do diabetes mellitus e as dificuldades do controle associado à ineficácia da logística adotada, principalmente no Sistema Único de Saúde. The Brazilian Health Care System stimulated for restrictive economic contexts had passed for reorganization in the decade of 1990, directed mainly to the primary attention. Although the reforms, the incidence of diabetes mellitus still reaches epidemic levels. The diabetes prevention has become actual preoccupation due the high morbimortality that accompanies this disease, becoming necessary the development of efficient and viable programs for Brazilian Public Health system such as emphasis in the primary prevention, control of the diseases incidence and complications. To obtain this goal, the current model of attention given to the patient must be modified, prioritizing the primary attention and a replacement of the hegemonic medical model for another one, formed by an interdisciplinary team, where the pharmacist as a member could offer his/her services should occur, thus minimizing social, humanistic and economic impacts that the diabetes causes for the society. The aim of this present revision is to approach the diabetes mellitus, the difficulties for its control associated with the adopted ineffective system, mainly in the Brazilian Public Health System.

Difficulties Found By Persons Living With Diabetes Mellitus: A Quantitative Analysis

“…In relation to public services, governments and leaders discuss the issue of drug supply and financing strategies, but few recognize that medicines are only a tool for delivering a service and generally do not care about structuring and Organization of this. The majority of pharmacies at the Basic Health Units (UBS) do not count on the presence of the pharmacist who could provide better assistance to the health user, presents reduced physical space and works mostly as a storage place for medicines and many Of the times, it has served only as a medicine delivery place, and there is no pharmaceutical-user interaction [21].…”

Carga do diabetes mellitus tipo 2 no Brasil

“…According to Guidoni et al 31 , the Family Health Strategy, currently the main primary care mechanism in the SUS, fails to fully meet with the prevention and health promotion recommendations for type 2 diabetes mellitus, thus generating gaps that are ultimately reflected in heavy expenditures on high-complexity expenditures for diabetics. Evaluating the profile of type 2 diabetes mellitus patients hospitalized in the SUS, Artilheiro et al 32 showed that the majority reported treatment for systemic arterial hypertension or some comorbidity associated with type 2 diabetes mellitus, such as DN, DR, or peripheral vascular disease.…”

Economic Evaluations in Health from the Perspective of the Costs Associated with Diabetes Mellitus Treatment

“…Thus, health services need to cope with rising costs in contrast to scarce resources [37]. This scenario becomes a challenge for the health system, considering the increase in the life expectancy of DM patients.…”