دورية أكاديمية
The process of implementation of emergency care units in Brazil.
| العنوان: | The process of implementation of emergency care units in Brazil. |
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| المؤلفون: | O'Dwyer G; Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil., Konder MT; Universidade Estadual do Rio de Janeiro. Faculdade de Ciências Médicas. Departamento de Clínica Médica. Rio de Janeiro, RJ, Brasil., Reciputti LP; Fundação Oswaldo Cruz. Iniciação Científica. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil., Lopes MGM; Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas e Estratégicas. Brasília, DF, Brasil., Agostinho DF; Fundação Oswaldo Cruz. Iniciação Científica. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil., Alves GF; Fundação de Apoio à Pesquisa do Estado do Rio de Janeiro Iniciação Científica. Escola Nacional de Saúde Pública. Departamento de Administração e Planejamento em Saúde. Rio de Janeiro, RJ, Brasil. |
| المصدر: | Revista de saude publica [Rev Saude Publica] 2017 Dec 11; Vol. 51, pp. 125. Date of Electronic Publication: 2017 Dec 11. |
| نوع المنشور: | Journal Article |
| اللغة: | English; Portuguese |
| بيانات الدورية: | Publisher: Universidade De Sao Paulo. Faculdade De Higiene E Saude Publica Country of Publication: Brazil NLM ID: 0135043 Publication Model: Electronic Cited Medium: Internet ISSN: 1518-8787 (Electronic) Linking ISSN: 00348910 NLM ISO Abbreviation: Rev Saude Publica Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Sao Paulo : Universidade De Sao Paulo. Faculdade De Higiene E Saude Publica |
| مواضيع طبية MeSH: | Health Policy*, Emergency Medical Services/*organization & administration , Health Plan Implementation/*organization & administration, Ambulances/organization & administration ; Brazil ; Emergency Service, Hospital/organization & administration ; Health Services Accessibility/organization & administration ; Humans ; Patient Care Management/organization & administration ; Qualitative Research |
| مستخلص: | Objective: To analyze the process of implementation of emergency care units in Brazil. Methods: We have carried out a documentary analysis, with interviews with twenty-four state urgency coordinators and a panel of experts. We have analyzed issues related to policy background and trajectory, players involved in the implementation, expansion process, advances, limits, and implementation difficulties, and state coordination capacity. We have used the theoretical framework of the analysis of the strategic conduct of the Giddens theory of structuration. Results: Emergency care units have been implemented after 2007, initially in the Southeast region, and 446 emergency care units were present in all Brazilian regions in 2016. Currently, 620 emergency care units are under construction, which indicates expectation of expansion. Federal funding was a strong driver for the implementation. The states have planned their emergency care units, but the existence of direct negotiation between municipalities and the Union has contributed with the significant number of emergency care units that have been built but that do not work. In relation to the urgency network, there is tension with the hospital because of the lack of beds in the country, which generates hospitalizations in the emergency care unit. The management of emergency care units is predominantly municipal, and most of the emergency care units are located outside the capitals and classified as Size III. The main challenges identified were: under-funding and difficulty in recruiting physicians. Conclusions: The emergency care unit has the merit of having technological resources and being architecturally differentiated, but it will only succeed within an urgency network. Federal induction has generated contradictory responses, since not all states consider the emergency care unit a priority. The strengthening of the state management has been identified as a challenge for the implementation of the urgency network. |
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| تواريخ الأحداث: | Date Created: 20171214 Date Completed: 20171218 Latest Revision: 20240327 |
| رمز التحديث: | 20240327 |
| مُعرف محوري في PubMed: | PMC5718113 |
| DOI: | 10.11606/S1518-8787.2017051000072 |
| PMID: | 29236876 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1518-8787 |
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| DOI: | 10.11606/S1518-8787.2017051000072 |