Integrating the primary health care and the specialized health care: Parallels between the brazilian and the Portuguese experiences

Abstract

This paper aims to analyze the processes developed in Brazil and Portugal intended to integrate the Primary Health Care and the Specialized Health Care. Primary Health Care conceived of as the first step for accessing to the health system stands out among the most usual initiatives and thus the family doctors are attributed a prevailing role. It is also emphasized the territorialization of the health services based on the geographic location, the referral to specialized doctors and the implementation of clinic protocols agreed between the parties. The main results indicate that in Brazil they implemented decentralized regulatory systems, and, in Portugal they created local health units (structures owned by the health ministry that integrate primary health care and specialized health care provided by the same management team). In conclusion, this work underlines the need to develop a true investment policy intended to strengthen the response capacity in the specialized health care and to add more value to the work performed by the primary care professionals. This way, they will strengthen the collaborative culture that will translate into successful integration processes with results such as good health and user's satisfaction.