Organização do sistema de referência e contra referência no contexto do sistema de saúde de Angola: a perceção de profissionais de saúde do Hospital Regional e do Hospital Municipal do Huambo
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2015
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A referência e a contra referência são um conjunto de procedimentos assistenciais e administrativos que se prestam de forma ordenada, com objetivo de assegurar a continuidade da resposta às necessidades de saúde dos utentes, com oportunidade, eficácia e eficiência, transferindo-se a prestação de cuidados da unidade de saúde de menor complexidade assistencial, para outra de maior complexidade, ou o inverso. Consideramos que o conhecimento da perceção dos profissionais que lidam com este sistema é bastante importante para a sua gestão. Este estudo teve como objetivo caracterizar a perceção dos profissionais de saúde do HRH e HMH sobre o sistema de referência e contra referência no contexto do sistema de saúde de Angola. O estudo baseia-se numa análise qualitativa, do tipo descritivo. A recolha de dados foi feita através de entrevista gravada a 16 profissionais com as categorias de médico e de enfermeiro dos serviços de BU e Consulta Externa com base num guião prévio, onde foi colocada uma questão geral sobre a vivência e perceção do sistema de referência e contra referência da unidade hospitalar. Com o objetivo de recolher mais informações colocamos mais 6 questões: (i) aspetos que favorecem o sistema, (ii) ações desenvolvidas, (iii) obrigações, (iv) como procedem, (v) vantagens e (vi) desvantagens. A discussão teve como base o diagrama de avaliação do acesso aos serviços de saúde proposto por Assis et all (2012). Concluiu-se que o sistema instalado é ainda insipiente, a contra referência não funciona, os participantes identificaram falhas no sistema ligadas a regulação da lei sobre a referenciação, problemas organizativos, técnicos e relacionais entre unidades e equipas, o que inviabiliza a premissa de o sistema tornar-se num mecanismo promotor do acesso e assistência integrais.
The reference and counter reference are a set of healthcare and administrative procedures that lend themselves in an orderly fashion, in order to ensure continuity of response to the health needs of users, with opportunity, effectiveness and efficiency, transferring to care health unit lower-complexity, to another more complex, or vice versa. We believe that knowledge of the perception of professionals who deal with this system is very important for its management. This study aimed to characterize the perception of health professionals of HRH and HMH on the reference and counter reference system in the context of Angola's health system. The study is based on a qualitative analysis, descriptive. Data collection was done through recorded interviews to 16 professionals with medical categories and nurse of BU and Outpatient services based on a previous script, where a general question about the experience and perception of the referral system was placed and against the reference hospital. In order to gather more information put more 6 questions: (i) aspects that favor the system, (ii) actions taken, (iii) obligations, (iv) and shall, (v) advantages and (vi) disadvantages. The discussion was based on the evaluation diagram of access to health services proposed by Assis et all (2012). It was concluded that the installed system is still incipient, the counter reference does not work, participants identified system failures related to regulation of the law on referral, organizational, technical and relational problems between units and teams, which prevents the premise of the system become a mechanism promoting access and full assistance.
The reference and counter reference are a set of healthcare and administrative procedures that lend themselves in an orderly fashion, in order to ensure continuity of response to the health needs of users, with opportunity, effectiveness and efficiency, transferring to care health unit lower-complexity, to another more complex, or vice versa. We believe that knowledge of the perception of professionals who deal with this system is very important for its management. This study aimed to characterize the perception of health professionals of HRH and HMH on the reference and counter reference system in the context of Angola's health system. The study is based on a qualitative analysis, descriptive. Data collection was done through recorded interviews to 16 professionals with medical categories and nurse of BU and Outpatient services based on a previous script, where a general question about the experience and perception of the referral system was placed and against the reference hospital. In order to gather more information put more 6 questions: (i) aspects that favor the system, (ii) actions taken, (iii) obligations, (iv) and shall, (v) advantages and (vi) disadvantages. The discussion was based on the evaluation diagram of access to health services proposed by Assis et all (2012). It was concluded that the installed system is still incipient, the counter reference does not work, participants identified system failures related to regulation of the law on referral, organizational, technical and relational problems between units and teams, which prevents the premise of the system become a mechanism promoting access and full assistance.
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Orientação : Cipriano Justo
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GESTÃO DE UNIDADES DE SAÚDE, POLÍTICA DE SAÚDE, CUIDADOS DE SAÚDE, ACESSO AOS SERVIÇOS DE SAÚDE, SISTEMAS DE SAÚDE, ANGOLA, HUAMBO, HEALTH CARE FACILITIES MANAGEMENT, HEALTH POLICY, HEALTH CARE, HEALTH SERVICES ACCESS, HEALTH SYSTEMS, ANGOLA, HUAMBO, MESTRADO EM GESTÃO DE UNIDADES DE SAÚDE