Subsídios norteadores para a implementação de ações programáticas a partir da necessidade de atualizar os Protocolos de Atendimento aos Pacientes com Hipertensão e/ou Diabetes na perspectiva de gestores, médicos e universidade

• Ano de defesa: 2014
• Autor(a) principal: Guerrero, José Manoel Amadio
• Orientador(a): Almeida, Fernando Antônio de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica de São Paulo
• Programa de Pós-Graduação: Programa de Estudos Pós-Graduados em Educação nas Profissões da Saúde
• Departamento: Faculdade de Ciências Médicas e da Saúde
• País: BR
• Palavras-chave em Português: Gestão em saúde; Protocolos clínicos; Saúde pública; Hipertensão; Diabetes Mellitus; Sistema Único de Saúde; Programas governamentais; Avaliação de programas e projetos de saúde
• Palavras-chave em Inglês: Health management; Clinical protocols; Public health; Hypertension; Diabetes mellitus; Unified Health System; Government programs; Program evaluation
• Área do conhecimento CNPq: CNPQ::CIENCIAS HUMANAS::EDUCACAO::TOPICOS ESPECIFICOS DE EDUCACAO
• Link de acesso: https://tede2.pucsp.br/handle/handle/9489

responsible for the care of about half of the patients in the primary care of the Unified Health System (SUS). Their clinical complications increase the rates of hospital admissions and mortality and bring serious personal and social consequences as well as for the health system. Objectives: 1. Starting from the historical process and experiences of some public servants involved, to explore and understand the Adult Health Program, where patients with hypertension and diabetes mellitus are cared; 2. To draw guiding subsidies for the effective implementation of program activities and clinical protocols in the network of municipal health care of Sorocaba. Methods: Analysis of documents and interviews were held to raise the profile of the physicians, the historical process, progress and challenges for programmatic care of hypertension and diabetes mellitus in the municipal health care of Sorocaba-SP. We interviewed 4 managers who had implanted and coordinated clinical protocols to attend hypertensive and diabetic patients in the SUS primary care in Sorocaba and 6 doctors who directly performed the care of these patients in the network. The 10 interviews were deepened, following script with open questions, which were recorded, transcribed and subjected to thematic analysis that used elements of Bardin and Minayo techniques. An interview was also conducted with a group of 4 coordinators and 2 supporters of basic health care units of a regional health care network of Sorocaba. This interview had characteristics of focus group, was recorded, transcribed and subjected to thematic analysis using the same technique previously described. The study took as reference the Theory of Social Representations of Serge Moscovici. Results: From the interviews and documental analysis it was recorded details of the implementation of the of Adult Health Program in Sorocaba-SP and 72 guiding subsidies that may contribute to the implementation of public policies, programs and clinical protocols were developed. Among them, we highlight the importance of having clear the institution mission and verify if the proposal of a given public policy meets the objectives of the municipal healthcare system; it is necessary to evaluate the technical, financial and political feasibility before implementing the action and review it at each change of local government; reducing the time spent on bureaucracy will facilitate the processes involved in medical consultation; preferably use active methods to make the training, such as case discussions, and training must occur during the physician working hours; as there are usually staff turnover, the training must be periodic; is important to monitor the implementation and results to the redesign and give feedback to healthcare team periodically; we need to ensure that care also favors non-drug treatments and health promotion; the university may be an important partner in the elaboration of public policies, and to this end, the planning of the training of health professionals and policy-making process must happen together. Conclusions: To effectively implement any protocol it is necessary to improve the management of services to ensure resources, deployment planning, team training and monitoring of results. The guiding subsidies proposed in this study can be useful to achieve better results when implementing programmatic healthcare actions