Acesso aos serviços de saúde: perspectivas de profissionais e usuários

Abstract

This is a qualitative case study, descriptive in character, based on the Comprehensive Sociology of Everyday Life. Its general objective is: To analyze access to health services from the perspective of users and health professionals and the specific ones are: To describe everyday situations that require the use of health services; To identify the technological work dispensed by health professionals to users; To understand the perception of users and professionals in the resolution of the actions undertaken within the health services. The study was conducted in three units of the Family Health Strategy Unit and the Emergency Department located in the municipality of Manhuaçu - MG. The participants of this study were 25 professionals working in the health units that served as a backdrop and 17 users of the health system. Data were collected from semi-structured interviews and observation and occurred in two stages: the first stage of data collection took place from February to April 2010, and the second one held in the months of November and December 2010. The data after transcripts were analyzed using content analysis proposed by Bardin. The data analysis allows us to infer that much of health care in the municipality occurs from the spontaneous demand of users, in a way that reaffirms the medical model-centered facing the disease. For the interest that presents itself is by appointment, usually medical, and referral to specialists and free distribution of medicines. It was evident that professionals face with manifestations of diseases that are strongly influenced by social context. In this sense, one can see that social demands are present and perceived by professionals working in the units of FHS who are sensitive to them, but do not seem to possess technological devices to solve them, because even require joint activities with other sectors of society. It was found that access to health services is given by the dimensions: geographical context, context and social demands, bonding with the host service, services offered, biological demands, beliefs / cultural demands and other demands. From this, it was developed the Matrix Multidimensional Assessment of Access, which allows evaluating the forces of attraction and repulsion in each of the dimensions that lead a user to access / use the service. It allows the identification of forces which, at that particular moment, would be overlapping the others, and would be leading the user to search for and under what conditions the health service. It is suggested that studies should be done in order to test the operationalization of the analysis from the Matrix and contemplate new nomenclatures, to account for formalizing the diagnoses that would fall on the social and cultural forces, in order to combine all available technologies that influence directly the issue of access, with a view to solving.