[Decentralization of health management:the path traveled to date, problematic points and prospects].

Abstract:

:The scope of this study was to analyze the decentralization of health management at city level and its implications for comprehensive access and care for users. A "scoping review" located 1,902 references. After being subjected to the criteria of inclusion and exclusion by judges, 27 articles were selected and charted. The research revealed the following issues: what it was possible to establish by the process; problematic points in charting the path and prospects of decentralization. The following aspects were identified: increased access to primary care through increasing the number of professionals and family health teams; planning, evaluation and inter-sector aspects were seen as problematic; planning and management instruments are limited, and cities face difficulties in relation to medium and high complexity care. Funding is still a barrier to the advancement of decentralization, few studies have analyzed the guarantee of access to medium and high complexity care and studies that define the reality of small cities are needed. Several challenges were identified, such as the need for implementation of the regionalization process, shared management and an inter-federative network that ensures comprehensive access to health care.

journal_name

Cien Saude Colet

journal_title

Ciencia & saude coletiva

authors

Pinafo E,Carvalho BG,Nunes Ede F

doi

10.1590/1413-81232015215.18942015

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

1511-24

issue

5

eissn

1413-8123

issn

1678-4561

pii

S1413-81232016000501511

journal_volume

21

pub_type

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