Práticas profissionais em saúde da família: uma análise do atendimento à demanda espontânea

Abstract

In Family Health Strategy, teams have to organize customer care, offering services both to priority groups and to the spontaneous demand, ensuring users comprehensive care through humane practices. These assumptions were taken as the basis for this research aimed at assessing the attendance to spontaneous demand and the factors that influence this care in the Family Health services. To this end, we carried out a qualitative study with the professionals in the teams of two Primary Health Care Units (UAPS) in Juiz de Fora. Data collection was carried out through focus groups. Speech was analysed using the method of thematic content analysis, which allowed us to create categories of analysis. In addition, we also analysed documents from the Municipal Health Department. The results show that the organization of attendance to users, by defining criteria for making appointments, creates barriers to its access. User embracement is a practice that has been incorporated by professionals, but aiming mainly at guiding the flow of users and organizing the demand for the physician. Excess demand leads to an overload of work for the doctor, making it difficult to deal with acute complaints. Attending the demand represents a dichotomy, seen also from the point of view of professionals; whereas spontaneous demand is considered to be assistential, curative, and oriented to the biological dimension of health needs and by the doctor’s attendance, programmatic demand, by contrast, is understood as a set of actions of fostering and prevention. We conclude that both the way that the attendance is organized and the views of the professionals create obstacles to full attendance to the growing demand in the Family Health Strategy and that it is necessary to offer the Family Health team both infrastructure and new instruments to deal with the demand.