Barretos’ County Matrix Support in Public Health - Deployment and Initial Results

Abstract

Aims: Brazil offers universal, integral and free healthcare to all its citizens through its Unified Health System (SUS). Within Brazil, the state of São Paulo has the most complex health network and comes closest to offering the comprehensive healthcare as per the guidelines of SUS. However, constraints to the system include a lack of integration and coordination between the basic healthcare network and specialty outpatient clinics, which hampers both proper access to specialties as well the return to basic care. This inefficiency feeds a pernicious cycle leading to waiting times for specialty care in excess of two years. Methods: In this article we describe the step-by-step implementation of an institutional and matrix support system between specialties and primary care in the county of Barretos, São Paulo, Brazil. Results: The initial results of this coordination and integration demonstrate the feasibility and excellent results such as the reduction in the need for referral to specialty clinics of up to 87%. Conclusion: Matrix support improved significantly the medical care and potentially can reduce costs as well. *Correspondence to: Adhemar Longatto-Filho, PhD, Molecular Oncology Research Center, Barretos Cancer Hospital/Pio XII Foundation, Brazil, Surgical Sciences Research Domain Life and Health Sciences Research Institute (ICVS) School of Medicine University of Minho, Campus de Gualtar, 4710-057 Braga – Portugal, Tel: +351253604827; E-mail: longatto16@hotmail.com or longatto@ med.uminho.pt