Rede de atenção à saúde bucal para pessoas com deficiência: desafios e potencialidades da atenção primária à saúde

Abstract

The health care networks are formed by health services at different levels and by the mechanisms of interaction between them, in order to provide and ensure comprehensive care to the population. One of the main attributions of primary health care is the organization of the trajectory of patients within the network, acting as a communication center between the different points. The present work aims to analyze the oral health care network for people with disabilities (RASB-PcD) and to identify the main challenges and potentialities so that primary health care (APS) can fulfill its coordinating role in this network. This is a qualitative, exploratory-descriptive research, whose data collection was carried out through focus groups and interviews with dental surgeons from primary health care; managers and dental surgeons of the dental specialty centers (CEO); managers and dental surgeon of the hospital dental care service, who work in the four health micro-regions under the jurisdiction of the regional health superintendence of Juiz de Fora. The technique chosen for data analysis was content analysis using Laurence Bardin's method, with the aid of the IRAMUTEQ software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires). Among the results, two categories of analysis emerged: the health care network for people with disabilities (RASBPcD) and the challenges and potentialities so that APS can fulfill its coordinating role in the RASB-PcD. In this study, it was identified that the referral flow in the RASB-PcD still has inconsistencies, despite being established, whereas the counter-referral flow shows weaknesses. Criteria and protocols for access to hospital services need to be better discussed and preoperative tests need to be performed in a timely manner. The offer of vacancies in specialized services and hospital services was identified as a challenge. Improving communication and articulation between professionals, through solid strategies of matrixial support and permanent education, emerged as a potential so that APS can coordinate care and guarantee its longitudinality, providing comprehensive care to people with disabilities.