在卫生区域实施残疾人护理网络的挑战:从政策、组织和结构的角度看

IF 0.5 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Saude E Sociedade Pub Date : 2023-01-01 DOI:10.1590/s0104-12902023220608en
Paulo Henrique dos Santos Mota, A. Bousquat
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引用次数: 0

摘要

残疾人(PWD)经历了深刻的社会不平等和获得健康。2012年建立了残疾人关怀网络(Rede de Cuidados Pessoa com Deficiência, RCPD),其目标是以公平和平等的方式改善这种机会。本文旨在分析RCPD在 jos do里约热内卢Preto卫生地区的实施和制约因素,以及RCPD的实施条件。这是一个探索性的案例研究,定性和定量的方法,锚定在公共政策分析工具。政策、组织和结构的维度指导了结果分析。对来自管理层、供应商和社会的37名关键参与者进行了访谈。卫生部被认为是确定政策和转移财政资源的主角。国家机构是RCPD领导小组的市政要求的服务提供者和调解人。辅助监管制度的缺失是网络组织发展的障碍。合同服务决定谁将获得医疗服务,而不尊重商定的流程。除专门康复中心外,康复服务的结构不是以保健需要为指导,而是以领土内现有的服务为指导。保障健康权的障碍是显而易见的,使残疾人所经历的不平等现象长期存在。
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Challenges for the implementation of the Care Network for Persons with Disabilities in a health region: a look from the dimensions policy, organization, and structure
Abstract People with Disabilities (PWD) experience profound inequalities both social and in the access to health. The Care Network for Persons with Disabilities (Rede de Cuidados à Pessoa com Deficiência, RCPD) was established in 2012, with the goal of improving this access in an equitable and equal manner. This article aims to analyze the implementation and constraints of the implementation and the conditionings of the RCPD in the health region of São José do Rio Preto. This is an exploratory case study, of qualitative and quantitative approach, anchored in the instrumental of public policy analysis. The dimensions of policy, organization, and structure guided the analysis of results. Interviews were conducted with 37 key players from management, providers, and society. The Ministry of Health is considered the protagonist in defining policy and transferring financial resources. The state agency is the service provider and conciliator of municipal demands by the RCPD leading group. The lack of an assistance regulation system is an obstacle to the network organization. Contracted services decide who will have access to care, not respecting agreed flows. The structure of rehabilitation services, with the exception of the Specialized Rehabilitation Center, was not guided by health needs but by the existence of services in the territory. Barriers to guaranteeing the right to health are evident, perpetuating the inequalities experienced by the PWD.
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来源期刊
Saude E Sociedade
Saude E Sociedade PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
0.90
自引率
16.70%
发文量
45
审稿时长
12 weeks
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