The model adopted by the State for the organization of the cancer care network was the .. Decreto n° de 28 de junho de Brasília. But as can be seen in the in the Greater ABC region of São Paulo, for example, the political side of this Most recently, in June , Decree nº 7,, regulating Law nº /90 dealing with the .. Decreto nº , de 28 de junho de
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Bousquat and Nascimento believe that inter-municipal competition makes it more difficult to balance health care service supply and demand in the region as the municipalities do not want to share resources with citizens who are not resident in their territory.
In order to understand the situation in the region, 16 key interviewees, managers who had participated directly or indirectly in the regionalization process between and were interviewed. According to Eliasregionalization of the health care system is inconceivable without effective state participation. It is impossible to imagine a regional health care system decrsto the presence of the municipal of the region and state sphere.
On the other hand, there is still difficulty, from all elements of the system, in prioritizing the adoption of management tools for clinical d and regulation. It should be highlighted that this situation makes it more difficult for the health care networks to treat the citizens, as the challenge lies in knowing defreto total population of the area around the network.
Dr the advances in inter-governmental relationships in the health care sector means clearly defining the contradictions, difficulties and limits of this process. The abolition of the DIR II, which had been responsible for the Greater ABC region, and for its transfer to the state capital, now in the form of the DRS I, seemed to be a step backwards in the search for more efficacy in health care activities in the Greater ABC area and, consequently, for improvements in the concept of the health care region, as recommended by the SUS.
In the proposed model for management of chronic conditions, the focus is on maintaining health and preventing disease in a defined population and the health conditions of this population. As in any complex secreto, we recognize that regulation allows that the diverse functions remain in operation within a predetermined target or limits so as to guarantee that the system as a whole achieves its basic objectives.
The regionalization process exposes one of the facets of the tension which manifests itself in the defence of federal entities, due to their marked socio-political differences. However, this Decree and its regulations do not explain the levels of the regionalization network, although they indicate the need to create health care networks. Data were collected between April and December Regional consciousness and identity, or regionality, involves inhabitants identifying themselves with their region, both inside and outside of it.
The coexistence of the specialists of the Reference Committee on Oncology with the technicians of the Health Department, the managers of the system, showed on the one hand the need for this approach to establish technical parameters to support the decisions and organization of services. National Center for Biotechnology InformationU. New accreditation rules for all services: The structures necessary for the treatment of cancer patients are highly complex.
Table 1 summarizes each of these publications 14 – It is possible to observe a direction for integral and integrated care.
Organization of the cancer network in SUS: evolution of the care model
We viewed the narrative as a structure of elements which crossed and interlinked with each other as if in a network, with intrigue, tension, confidence and collusion, a chain of events or storylines which constituted the action of the process of SUS regionalization in the Greater ABC area inthe year in which the narrative occurred. It is also within these territories that Thematic Networks must be organized e. Difficulties in harmonizing federal interests. Reference Center I and II for hospitals, with I being totally dedicated to oncology and more edcreto radiotherapy and chemotherapy centers isolated from hospitals.
There are divergences and conflicts of interest between the municipalities themselves, and between them dexreto the State.
Installed in a story building were beds for hospitalization, 11 operating rooms, armchairs for outpatient chemotherapy infusion, 63 surgeries and 6 linear accelerators. Remaking health care in America.
Organization of the cancer network in SUS: evolution of the care model
This practice not only harms the agreements established in the CGR, but also weakens the municipalities’ meeting of technical and financial obligations. Although we have observed evolution in the regulation of cancer care in SUS, there are still many challenges for the establishment of the Oncology Network in the integrated care model.
This article intends to reflect on the process of regionalization from an administrative and political point of view, highlighting issues of local autonomy due to the process of municipalization. The abolition of the DUR II made it difficult to view health care in that catchment area as a regional question, as it competed with the coordination of health care actions 5708 at a local level. We have to recognize that secreto a regional health care system needs the willing participation of the three parts of the federation, thus seeking to ensure comprehensive care for the citizen.
Although citizens have every right to travel from one municipality to another, this causes problems for health care managers due to technical and administrative criteria. This feeling of pride at belonging to the municipality has encouraged rivalries among the others, thus accentuating municipal pride. In addition, a challenge 201 to early detection was observed since In the OSS management model, a private organization administers the hospital through a contract that provides goals and results.
According to the statements we heard, some of the expected effects would be: The Portaria changed the focus of habilitation, leading to the need for regional discussions and the elaboration of care plans that considered the network that included the establishment to be enabled. Together with the DRSs, the CGRs are responsible for altering directives, objectives, aims and indicators, according to the reality and peculiarities of the local areas.
As an area classified within the High Complexity of SUS, in which the manager requires compliance with deccreto parameters for the service provider, Ministerial Ordinances are important drivers of the establishment of care models and the implementation of management culture. Among the barriers to integration are the inability to understand the new business edcreto in which primary care is the center of care and the well-being of the target population becomes the focus of the expected results.
RESULTS In Brazil, cancer ceased to be a disease treated only in medical offices and became a public health problem in with the Anticancer First Plan and the inauguration of the Radium Institute in Belo Horizonte, a private entity and the first center to fight cancer in the country. For the interviewee from the ABC Foundation there is an ” optimism in defreto in consolidating this space of inter-federative management, considering that recent health care policies have included the CGR as a space for formulating and executing its actions “.
In the Greater ABC area, once again, we observe that each of the seven municipalities in the region prioritize themselves over the region, as they draw up their municipal 77508 care plans in isolation, with little decreyo no contact with regional bodies. Each RRAS must have a sufficient capacity for basic care, medium-complexity services and some high-complexity services. Strengthening of SUS regionalization is through better integration of all of the municipalities and, above all, through a less passive, more engaged and proactive participation.
National Cancer Care Policy: