Atenção especializada na perspectiva de integração à rede de atenção à saúde: uma análise a partir da Policlínica Regional de Vitória da Conquista

Abstract

The objective of this research was to analyze the offer of Specialized Care (SA) and health transport of the regional polyclinics implemented in Bahia, through the Interfederative Health Consortia, focusing on the experience of the Regional Health Polyclinic of Vitória da Conquista and Itapetinga, considering the attributes of the Specialized Care offer according to the molding of the Health Care Networks, from the perspective of the subjects who participated in the implementation process of the same, as well as those who work in the management and direct assistance to the user. This is an exploratory and instrumental case study, with a qualitative approach, covering two stages of research, the first being between May and June 2021, aimed at interviewing managers and managers, totaling 19 people. The second stage took place between October and November 2022, and consisted of interviewing 09 workers from the polyclinic and health transport. The collection instrument used was a semi-structured script. Thematic content analysis was carried out based on the following dimensions: Planning of EC supply and health transport based on regional health needs; Elective sanitary transport; Regulated access and care coordinated by the APS; Integration with other RAS points and professionals in the health region; Multiprofessional care in the EC; Electronic medical records, clinical protocols and access to EC shared with municipalities and APS; Integration and communication between AE and social/population control; Matrix function, Continuing Education, teaching-service integration and research in the AE; Referral and counter-referral flows; Permanent education and space for professional training; Role of the regional polyclinic in the production of specialized care. Among the results found in the two phases of the research are advances such as the expansion of the supply of EC, with guaranteed medical transport; enabling the retention of qualified professionals; monitoring of AE provision; advances in regulation through the operating system; existence of initiatives such as the Caminhos do Cuidar Project, which aims to monitor compliance with the sixty-day law for cancer patients; care aimed at patients with complications from diabetes; permanent education aimed at professionals in partnership with institutions such as the Center for Attention and Support to Life (CAAV), Health Department of the State of Bahia (SESAB). As challenges, difficulties emerged in the referral and counter-referral process; lack of electronic clinical records that are shared between the polyclinic and other points of care; need for greater incentives aimed at permanent education and teaching-service integration and research; construction of communication channels between AE and APS, among others. Based on this, it was concluded that even with important advances in the process of expansion of the EC, adjustments are still necessary that allow its functionality in a resolute and integrated way, based on the PASA model, articulating with the other points of attention and to Therefore, strengthening PHC would be one of the most urgent aspects to be conquered.