Artículos de revistas
Regionalization and access to healthcare in Brazilian states: historical and political-institutional conditioning factors
Fecha
2013-08-02Registro en:
CIENCIA & SAUDE COLETIVA, RIO DE JANEIRO, v. 17, n. 11, supl. 18, Part 1-2, pp. 2881-2892, NOV, 2012
1413-8123
10.1590/S1413-81232012001100005
Autor
de Lima, Luciana Dias
d'Avila Viana, Ana Luiza
Machado, Cristiani Vieira
de Albuquerque, Mariana Vercesi
de Oliveira, Roberta Gondim
Iozzi, Fabiola Lana
Gurtler Scatena, Joao Henrique
Mello, Guilherme Arantes
Mendes Pereira, Adelyne Maria
Santana Coelho, Ana Paula
Institución
Resumen
This article examines the healthcare regionalization process in the Brazilian states in the period from 2007 to 2010, seeking to identify the conditions that favor or impede this process. Referential analysis of public policies and especially of historical institutionalism was used. Three dimensions sum up the conditioning factors of regionalization: context (historical-structural, political-institutional and conjunctural), directionality (ideology, object, actors, strategies and instruments) and regionalization features (institutionality and governance). The empirical research relied mainly on the analysis of official documents and interviews with key actors in 24 states. Distinct patterns of influence in the states were observed, with regionalization being marked by important gains in institutionality and governance in the period. Nevertheless, inherent difficulties of the contexts prejudice greater advances. There is a pressing need to broaden the territorial focus in government planning and to integrate sectorial policies for medium and long-term regional development in order to empower regionalization and to overcome obstacles to the access to healthcare services in Brazil.