Artigo de Periódico
Cidadãos peregrinos: os "usuários" do SUS e os significados de sua demanda a prontos-socorros e hospitais no contexto de um processo de reorientação do modelo assistencial
Travelling citizens: the "users" of the Brazilian Unified Health System and the meanings of its demand to the health care emergency services in the context of a process of assistential model reorientation
Autor
Oliveira, Lúcio Henrique de
Mattos, Ruben Araújo de
Souza, Auta Iselina Stephan de
Institución
Resumen
Despite the emphasis of the territorial logic on the first level of the public health services network, the users of this health system come demonstrating a historical preference by emergency services. In order to try to understand this behavior, a Qualitative Research was developed, by means of interviews with "Foci Groups" of public health services users, where it was searched to know their experiences, perceptions and opinions, looking for understanding how do they choose during their search for assistance. The users reject the "norm" that defines the basic health care services of their territorial reference as their "entrance door", in favor of other parameters that were more significant for them. The arrangements of the health care organization have the meaning of barriers to the access. Moreover, the user's image in relation to the UBS is of great limitation. On the other hand, the emergency services present for them as spaces characterized by bigger capacity. The users demonstrate a significant indifference about the public health services. Besides, the uncertainty's images prevail in the SUS. But, according to its access necessity, the users learn social rules in the services and construct several strategies with the aim to open the doors of the health system. Apesar da ênfase dada à lógica territorial no processo de reorientação do modelo assistencial e da definição da atenção básica como porta de entrada do sistema, os usuários do SUS, em sua busca por assistência médica, vêm demonstrando historicamente preferência por prontos-socorros e hospitais. Para tentar entender esse comportamento, realizou-se pesquisa com grupos focais de usuários, em que se verificou que a imagem que o usuário faz dos serviços de saúde se relaciona com a acessibilidade, a confiabilidade e a resolubilidade do serviço buscado. Os usuários se referem à organização dos serviços básicos de saúde com o significado de barreiras ao acesso e demonstram ter em relação às UBS uma imagem de grande limitação de recursos humanos e materiais. Por outro lado, prontos-socorros e hospitais se apresentam para eles, por várias razões, como espaços de maior resolubilidade. A partir de sua necessidade de acesso, os usuários apreendem determinadas "regras sociais" vigentes nos serviços de saúde e constroem diversas estratégias que visam lhe abrir as portas do sistema.
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