A atenção primária à saúde na coordenação das redes de atenção: uma revisão integrativa – ScienceOpen
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      A atenção primária à saúde na coordenação das redes de atenção: uma revisão integrativa Translated title: Primary Health Care in the coordination of health care networks: an integrative review

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          Abstract

          Os sistemas de saúde, organizados em Redes de Atenção e coordenados pela Atenção Primária à Saúde, podem contribuir para a qualidade clínica, com resultados sanitários de impacto positivo, na satisfação dos usuários (pela melhoria do acesso e resolubilidade) e na redução dos gastos dos sistemas locais de saúde. Dessa forma, propôs-se analisar a produção científica acerca das evidências, potencialidades, desafios e perspectivas da Atenção Primária à Saúde na coordenação das Redes de Atenção. Para atingir o objetivo, definiu-se como método a revisão integrativa, considerando o período temporal de 2000 a 2011. As bases de dados selecionadas foram Medline (Medical Literature Analysis and Retrieval Sistem on-line), Lilacs (Literatura Latino-Americana em Ciências de Saúde) e SciELO (Scientific Electronic Library Online). Atenderam aos critérios de seleção 18 artigos. Pode-se observar que as potencialidades acerca dos serviços de Atenção Primária se sobressaíram às fragilidades. Contudo, destaca-se a necessidade de pesquisas com maior nível de classificação das evidências científicas sobre a atuação da Atenção Primária à Saúde na coordenação das Redes de Atenção.

          Translated abstract

          Health systems organized in health care networks and coordinated by Primary Health Care can contribute to an improvement in clinical quality with a positive impact on health outcomes and user satisfaction (by improving access and resolubility) and a reduction in the costs of local health systems. Thus, the scope of this paper is to analyze the scientific output about the evidence, potential, challenges and prospects of Primary Health Care in the coordination of Health Care Networks. To achieve this, the integrative review method was selected covering the period between 2000 and 2011. The databases selected were Medline (Medical Literature Analysis and Retrieval System online), Lilacs (Latin American Literature in Health Sciences) and SciELO (Scientific Electronic Library Online). Eighteen articles fulfilled the selection criteria. It was seen that the potential impacts of primary care services supersede the inherent weaknesses. However, the results revealed the need for research with a higher level of classification of the scientific evidence about the role of Primary Healh Care in the coordination of Health Care Networks.

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          As redes de atenção à saúde

          As transições demográfica e epidemiológica significam um incremento relativo das condições crônicas. Tem sido assim, no Brasil, que apresenta uma situação de saúde de tripla carga de doenças, manifestada na convivência de doenças infecciosas, parasitárias e problemas de saúde reprodutiva, causas externas e doenças crônicas. Há uma crise dos sistemas de saúde contemporâneos que se explica pela incoerência entre uma situação de saúde com predomínio relativo forte de condições crônicas e uma resposta social através de sistemas fragmentados e voltados, principalmente, para as condições agudas e as agudizações das condições crônicas. Essa crise se manifesta em nosso país, tanto no setor público quanto no setor privado. A solução para essa crise está em recompor a coerência entre a situação de tripla carga de doenças com uma resposta social estruturada em sistemas integrados de saúde: as redes de atenção à saúde. Conclui-se que há evidências na literatura internacional de que as redes de atenção à saúde podem melhorar a qualidade dos serviços, os resultados sanitários e a satisfação dos usuários e reduzir os custos dos sistemas de atenção à saúde.
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            The breadth of primary care: a systematic literature review of its core dimensions

            Background Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. Methods A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Results Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. Conclusions A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health.
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              As Redes de Atenção à Saúde

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
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                Role: ND
                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro )
                1413-8123
                February 2014
                : 19
                : 2
                : 343-352
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                Article
                S1413-81232014000200343
                10.1590/1413-81232014192.18032012
                b08e5fae-d634-4bfb-8ea1-3aa8ad2c64eb

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=1413-8123&lng=en
                Categories
                Health Policy & Services

                Public health
                Primary health care,Intersectoral action,Health care networks,Coordination of care,Atenção primária à saúde,Ação intersetorial,Redes de atenção à saúde,Coordenação dos cuidados

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