Cartography of Specialized Care in the System Unified Health System (SUS): formulation, training and management in care networks

Abstract

In Brazil, specialized care (SC) is one of the main "critical nodes" of the Unified Health System (SUS). The aim of the research is to support the formulation and implementation of the Specialized Health Care Policy in the SUS. The proposed study is not limited to research into the policy, but aims to contribute to SUS managers at national, state and municipal level in the process of critical analysis and reformulation of the policy itself. To this end, a qualitative, multicentre study will be carried out in partnership with the team from the Ministry of Health's Specialized Care Secretariat (SAES), in close coordination with the Decentralized Execution Term (TED) signed between the Ministry of Health and the Federal University of São Paulo (Unifesp). Based on a multidimensional situational diagnosis carried out in all the Brazilian states, the investigation will delve deeper into the country's five regions by means of in-depth analysis in 9 Federated Units and the Federal District. In each state, two to three health regions will be studied, indicated by SAES-MS, based on the following criteria: a) health region in the capital and in the interior; b) presence of a University Hospital managed by the Brazilian Hospital Services Company (EBSERH). Four devices will be used to produce and analyze the information: 1. Shared regional seminars; 2. Production of a virtual platform, linked to UNIFESP and SAES-MS, to collect information and set up a real-time information network for the Interfederative Forum on SC within the scope of the Ministry of Health; 3. Mapping of successful experiences in specialized care in the country and in other national health systems through the following procedures: a) Open interviews with service teams responsible for innovative arrangements in the field of SC management, care and governance, b) Observation and open interviews with users in the waiting rooms of the services listed, c) Literature review on SC organization arrangements and models, d) Technical visits to learn about other countries' experiences in organizing the SC network; 4. Training of network care management learning advisors and managers: training-intervention processes with managers, regulatory professionals and health service managers in 19 health regions in the logic of Continuing Education, aimed at building SUS management and governance strategies for the production, evaluation and monitoring of regional Specialized Care networks. The hope is to create a PNAES that is planned and implemented through strengthened regional governance, financed through models that induce the intended transformations, based on arrangements for matrix support, regulation, telehealth and continuing education strategies that guarantee continuity of care in regional networks, integrated into the primary care and hospital care networks.