O SAMU, a regulação no Estado do Rio de Janeiro e a integralidade segundo gestores dos três níveis de governo

Abstract

The SAMU is a priority politics for the present government. This study aimed to discuss the potential of integral care practices within the SAMU, analyzing the care to the emergency cases by key management actors. Methodology was based on Giddens's Structuration Theory, linking structure and action, which was investigated by means of discursive consciousness. We interviewed managers of three federal entities which related their regulation practices of SAMU in the State of Rio de Janeiro. The axes of analysis were: the SAMU, its features, functions, and social issue, the doctor, his profile, attitudes and clinical decision making, and assistance in networking, management and regulation. No integrated assistance for structural failure of primary care and precariousness in the referral hospitals was pointed. Precarious training and employment relationships hinder the management in the SAMU. There was ineffectiveness of the management committees of various levels and there was no information production. It was highlighted the privilege of regulation as a monitoring system and attention to the emergency room to evaluate the performance of the network and the regionalization of care.