O acesso a medicamentos pela via administrativa no setor público de saúde no Brasil

• Ano de defesa: 2015
• Autor(a) principal: Soares, Amanda Queiroz
• Orientador(a): Amaral, Rita Goreti
• Banca de defesa: Amaral, Rita Goreti, Dâmaso, Andréa Homsi, Andrade, Eli Iola Gurgel, Medeiros, Marcelo, Contezini, Silvana Nair Leite
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Programa de Pós-graduação em Ciências da Saúde (FM)
• Departamento: Faculdade de Medicina - FM (RMG)
• País: Brasil
• Palavras-chave em Português: Assistência farmacêutica; Medicamentos essenciais; Acesso aos serviços de saúde; Direito à saúde; Sistema Único de Saúde; Sistemas de saúde; Política de saúde; Brasil
• Palavras-chave em Inglês: Pharmaceutical services; Essential medicine; Health services accessibility; Health law; Unified Health System; Health policy; Health systems; Brazil
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::SAUDE COLETIVA
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/12825

Although the Brazilian public healthcare system is based on the principles of the universality and integrality of access to health services, severe problems remain with respect to guaranteeing access to pharmaceutical drugs. This situation has contributed to the creation of new institutional frameworks, including the administrative channel, institutionalized by the executive power with the aim of meeting the repressed demand for pharmaceutical drugs not obtained within the public health service. This study analyzed access to pharmaceutical drugs through the administrative channel within the Brazilian public health sector. As part of this larger study, various methodologies were applied, including a case-control study, a descriptive study and an interpretive case study in which the focal group technique was used. The study was developed in the town of Goiânia, in Brazil’s mid-western region. General users of primary healthcare units (or their accompanying persons), users specifically requesting pharmaceutical drugs through the administrative channel and users who had successfully obtained pharmaceutical drugs through this channel participated in the study. Results show that administrative demands for access to pharmaceutical drugs are inserted within a multifactorial context that involves users’ economic and sociodemographic characteristics, as well as the characteristics of healthcare, pharmaceutical care and healthcare conditions. Furthermore, users who had gained access to at least one pharmaceutical drug requested through the administrative channel were found to be predominantly those who were less socioeconomically vulnerable, those with a positive self-evaluation of their state of health, those requesting insulin analogs and individuals who in general did not consult or obtain medication within the public healthcare sector. The steps taken by most of the individuals who had their request approved reveal their fluidity between the public and private healthcare sectors, characterizing their efforts to guarantee healthcare. Therefore, the administrative channel was found not to be free from the barriers to achieving access to pharmaceutical drugs that exist within the public health sector in view of its interdependency on a system with shortcomings both within the health sector itself and at higher levels within the system.