O CUIDADO INTEGRADO NA SAÚDE SUPLEMENTAR DO BRASIL: UMA DISCUSSÃO ATRAVÉS DA METODOLOGIA DELPHI
DOI:
https://doi.org/10.25194/rebrasf.v7i1.1189Palavras-chave:
Idoso. Doenças crônicas. Saúde suplementar. Modelos assistenciais de saúde.Resumo
Introdução: O cuidado integrado é um modelo de atenção presente em vários sistemas de saúde. No Brasil, especificamente no setor privado, não está consolidado por vários motivos, como: incompreensão conceitual do modelo, a falta de identificação do papel do coordenador da atenção e ausência de indução da Agência Nacional de Saúde. Objetivo: discutir o cuidado integrado para o cuidado do idoso portador de doença crônica no sistema de saúde privado. Método: estudo descritivo, exploratório, qualitativo, através de uma entrevista semiestruturada com 9 (nove) especialistas. Resultados: todos entrevistados responderam aos questionários com respostas atreladas a distintas categorias, como conceito, elementos do modelo, a relação com operadoras e as barreiras ao desenvolvimento do modelo. Discussão: não houve consenso entre os entrevistados em relação ao conceito e elementos que o compõe, mas sim que a falta de pactos sociais/cultura da sociedade/família na responsabilidade compartilhada de cuidar dos idosos e a judicialização da assistência foram sugestões comuns de aspectos que impedem o desenvolvimento do modelo. Conclusão: há barreiras a serem transpostas para a consolidação do modelo e para isso seria necessário: (i) elaborar diretrizes para implantar uma coordenação de atenção à saúde nos moldes das ações da atenção primária em saúde; e (ii) reconhecer a importância de análises epidemiológicas.
ABSTRACT
Introduction: Integrated care is a model of attention present in several health systems. In Brazil, specifically in the private sector, it is not consolidated for several reasons, such as conceptual misunderstanding of the model, lack of identification about the role of the coordinator of care and absence of induction of the National Health Agency. Aims: to discuss the care of the elderly with chronic illness in the private health system. Method: descriptive, exploratory, qualitative study, through a semi structured interview with 9 specialists. Results: all respondents answered the questionnaires with answers linked to different categories, such as concept, elements of the model, the relationship with operators and barriers to the development of the model. Discussion: there was no consensus among the interviewees regarding the concept and elements that compose it, but rather that the lack of social/cultural and pacts of society/family in the shared responsibility of caring for the elderly and the judicialisation of care were common suggestions of aspects that prevent the development of the model. Conclusion: there are barriers to be transposed to consolidate the model and for this it would be necessary to: (i) elaborate guidelines to implement a coordination of health care in the framework of actions to primary health care and (ii) recognize the importance of epidemiological analysis.
Keywords: Elderly. Chronic diseases. Supplemental Health. Health. Healthcare Models.
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