Estruturação da rede de atenção à saúde na perspectiva de profissionais, usuários e cuidadores da atenção domiciliar

Abstract

This study aimed to understand the structure of the network of health care from the perspective of professionals, caregivers and users of home care in the city of Ipatinga, Minas Gerais. We used the qualitative case study as a methodological way. The scenario was composed by home care program bound to a hospital in Ipatinga. The subjects of the investigation healthcare professionals of this service being a nurse, a doctor, a nurse technician and a physiotherapist. Subjects were also eight users of this type of service over 18 years, of both sexes, being assisted by the home care team. In specific situations, where users admitted to home care were not able to communicate verbally caregivers were included, totaling seven subjects in this category. Data collection was conducted through interviews with semi-structured and journaling field. Data from the interviews were recorded, transcribed and analyzed using the technique of thematic content analysis, having emerged the following empirical categories: "Structuring the Network of Health Care in the city of Ipatinga, between the real and the prescribed"; "The walk Network Health Care: trajectories of users and caregivers of home care" and "(Des)Linking health services: challenges and opportunities". The results showed contradictions regarding the structure of the network of health care in Ipatinga, the emerging gap between the prescribed and actual. The paths traveled by users and caregivers seeking health care were highlighted, demonstrating the need for interdependence and complementarity between the services that make up the network of health care in order to ensure comprehensive care. Were also highlighted issues related to the challenges and opportunities inherent in networking. Among the challenges highlighted the difficulty of linkage with primary care services and unaccountability professional user; deficiency of communication between departments; imbalance between demand and supply, and management practices in health services. Among the opportunities, showed up practical reference and counter, integration with other services through telephone contact, reporting practices and high intersectionality. It is considered that home care is an important space in the reorganization of health work and the reorganization of health care. It is noteworthy that involvement initiatives, coordination, interaction and integration with other health services are primary reasons for reaching the assumptions of the network of health care.