Análise da programação pactuada e integrada da assistência em saúde: o estabelecimento de pactos e a alocação de recursos em uma região de Minas Gerais

Abstract

The Agreed and Integrated Programming of Health Care (PPI) is an important instrument for the planning of health actions in which the medium and high complexity actions for the resident population are defined and quantified, also as the inter-manager agreements for access of the referenced population. The objective of this study was to analyze the effectiveness of the PPI in relation to outpatient and hospital care in the area covered by the Regional Health Management of Juiz de Fora through a retrospective descriptive exploratory study of the years 2014 and 2015. The tabulation of PPI data, from SES/MG, was performed in Microsoft Access software and the production data (SIA and SIH) available in DATASUS by TabWin. Information regarding assistance networks and installed capacity were obtained in the SCNES. Descriptive analyzes among the databases using Microsoft Excel identified the compatibility between outpatient and hospital care provided to the population and the programmed in the PPI in relation to physical and financial goals. Some of the 37 municipalities presented good agreement between programming and production for some analyzes, however in the majority there was idleness or lack of physical and/or financial resources in PPI. Some criticisms identified were: allocation of resources for hospital referral in municipalities without active hospitals; excessive allocation of resources in some municipalities with low productive capacity; and deviations in attendance flows when compared to the Regionalization Master Plan. It is concluded that PPI is still not used in a full and efficient way, but it guarantees an improvement in the equity of resource allocation and the structuring of attention networks, and it is important to move towards a shared and solidary management practice for the structuring of regionalised networks effective.