Uma avaliação da confiança e acesso entre instituições componentes da rede assistencial sobre drogas: uma abordagem por análise de redes sociais

Abstract

Introduction: It is estimated that 1 in 20 adults in the world, or a quarter of a billionpeople between 15 and 64, used at least some type of illicit drug in 2014, of that total, morethan 29 million people who use drugs will suffer inconvenience from its use. With an effecton individual and collective health, drug use must be addressed broadly, encompassingprevention, treatment, care, and support. Due to these and other pressures, there is a growingneed to design and implement evaluations in health systems, evaluations that help in thedecision-making of actors, at all hierarchical levels, based on solid scientific knowledge. InBrazil, health systems are organized through a logic of care networks, so the AssistanceNetwork on Alcohol and Other Drugs should be seen in an expanded way, as a combinationof resources from governmental services of the Health Care Networks, Psychosocial, UnifiedSocial Assistance System and community resources. Objective: To explore a model ofevaluation of health services that are components of a network through the Analysis of SocialNetworks (SNA), presenting possibilities of analysis, through the case study of themunicipality of Juiz de Fora, MG, to identify the typology and characteristics of theinteractions established between the different elements of the network; understand therelationships between the centrality metrics of the network nodes in the different dimensionsevaluated. Methods: Mapping of Network services through analysis of national databases,identification of central actors and snowball. Data collection in interviews with servicemanagers/professionals indicated. Analysis of the metrics of Degree Centrality, BetweennessCentrality, Closeness Centrality and Transitivity. Use of Principal Component Analysis andgeneralized linear models. Results: Three components were responsible for the greatest variation in the data. In networks of trust and access, Social Assistance is the sector with thehighest level of activity, connections, cohesion, efficiency, and importance in the flow ofinformation, and the Third Sector has the opposite situation. On the other hand, the ThirdSector is the one with the greatest possibility of forming clicks with adjacent services. Conclusion: The method presented is relevant to health assessment, it can be applied in othercontexts or places with due adaptation, being able to use the most diverse statistical analyzestogether with the SNA to better evaluate the networks.