Gestão do cuidado integral: Estudo de caso em região de saúde da Bahia, Brasil

Abstract

This study analyzed management of comprehensive care in a health district in Bahia State, Brazil, at the political, institutional, organizational, and health­care practice levels and the challenges for establishing coordinated care between municipalities. The infor­mation sources were semi-structured interviews with administrators, focal groups with healthcare profes­sionals and users, institutional documents, and ob­servations. A comprehensive and critical analysis was produced with dialectical hermeneutics as the refer­ence. The results show that the Inter-Administrators Regional Commission was the main regional gover­nance strategy. There is a fragmentation between vari­ous points and lack of communications linkage in the network. Private interests and partisan political inter­ference overlook the formally agreed-upon flows and create parallel circuits, turning the right to health into currency for trading favors. Such issues hinder coordi­nation of comprehensive care in the inter-municipal network.