Acesso à atenção primária à saúde em municípios de uma região de saúde de Minas Gerais

Abstract

It is a multiple case study, qualitative approach in order to analyze access from the primary health care professionals from the perspective of family health teams and users. The term access is understood from the perspective of the user search for care and its entry into the health care system, how to use the services and the answers that are given to their demands. The study scenarios were the municipalities of Ipatinga, Coronel Fabriciano and Santana do Paraíso, in the State of Minas Gerais. Participants were 12 health professionals from 12 different categories and users, with four of each municipality. The data were collected through interviews from a semi structured script for each segment studied, recorded in digital media, transcribed and analyzed using content analysis of Bardin. The data were organized into two major categories and subcategories: 1. Access in different scenarios of a regional health state of Minas Gerais: sense and counter sense; Ipatinga: dissatisfaction of all facts and unanimous, Coronel Fabriciano: dichotomy of looks; Santana do Paraíso: between theory and practice. 2. The interrelation of the counties upon the rhetoric of access; access the APS and the daily work: spacing between the desired and actual; Increased access: implications for the organization of health services; Amplifiers for the quality of access. As a result practitioners believe that it is possible to improve working conditions and consequently the offering of services. The type of care and its complexity make the difference in waiting time and responsiveness of the system improving the quality of access. Professionals in the municipalities of Coronel Fabriciano and Santana do Paraíso consider the service organized and decisive. On the other hand, in the city of Ipatinga, there is a management turnover that hampers the service organization and the establishment of flows and routines. From the users point of view the quality of the services needs improvement, both in technical assistance, as well as in assistance humanization. The long waiting periods for triage and follow up between the levels of attention was present in all of the municipalities, being one of the points to be superseded. The users from Ipatinga municipality were unanimous in demonstrating dissatisfaction with the services, moreover with the care and offering approach. In Coronel Fabriciano opinions were heterogeneous in what relates to care, but the excessive wait was mentioned by all. In Santana do Paraíso, the main critical knots were the queues to set an appointment and the lack of preparation of the team in what concerns care for the community. The conclusion is that the health care needs to be rethought, the integrality of the care assistance is out of the municipalities hands, which means a reduction of care capacity in giving the answers that the population needs, regardless if they relate to technology availability, waiting reduction, or even the caring humanization or ethical commitment to the health or sickness processes of people that chase SUS care.