Coordenação do cuidado pela atenção primária à saúde na atenção às pessoas com doenças crônicas na região norte do Espírito Santo

Abstract

In the last decades, there has been a significant increase in chronic diseases in the world population. Thus, it is necessary to organize health services in order to offer comprehensive and continuous care to individuals with chronic diseases, since they are frequent users of health services and need to access different points of the care network, being more susceptible to experience a fragmented care. Therefore, the development of care coordination by Primary Health Care (PHC) has been considered an essential attribute in the care of people with chronic diseases. Thus, the aim of this study was to understand the role of PHC in coordinating care for people with chronic diseases. This is a study that was developed by using two methodological approaches: a scoping review of the literature, carried out during the month of May 2021, in the MEDLINE, LILACS, Web of Science and EMBASE databases; and a study with a qualitative approach, carried out in a health region in the state of Espírito Santo, where data were collected through individual interviews with managers and health professionals, using a semi-structured script. The qualitative research data were analyzed using the thematic analysis technique proposed by Braun and Clarke. From the review, it was possible to identify some barriers in the development of care coordination in the care of people with chronic diseases, related to the integration between the different teams and services, the responsibility for care coordination and informational continuity, considering the configuration of the health services. In the qualitative approach research, the participants highlighted challenges and efforts related to the development of care coordination that cross all the pillars that compose this attribute (clinical coordination; administrative/organizational coordination; information coordination), highlighting that such challenges were intensified during the Covid-19 pandemic period. In general, it was possible to understand the complexity in the development of care coordination in the care of people with chronic diseases, and that it is necessary to intensify efforts that contribute to the realization of this attribute. Thus, it is essential that existing strategies are strengthened and that innovative proposals are carried out both in the scope of macro-management and micro-management.