A rede de urgência e emergência da macrorregião norte de MinasGerais: um estudo de caso

Abstract

Emergency health care is a challenge to be faced by the Unified Health System and demands organization from the health managers. Issues such as demographic changes and increased numbers of accidents contribute to a more frequent utilization of services, making theirstructuring even more urgent. The State Secretary of Health of Minas Gerais (SES/MG), with the purpose of organizing the emergency health care in the state, has proposed the implementation of the Emergency Network in the Northern Macro-region of Minas Gerais. This research is aimed to understand the functioning of this network through studying its Managerial Committee (CG). The specific objectives were to describe the implementation process as well as the organizational dynamics of the Managerial Committee, identify the obstacles faced by the project, and also the positive aspects which can contribute to the process of implementing andmanaging the Emergency Network in the Northern Macro-region of Minas Gerais, and systemizes the proposals presented in order to better the functioning of the RAUE/MNMG. It consists of qualitative and exploratory research in the form of a case study. The data was collected through documental research, observation and interviews with key personnel, members of the Managerial Committee and rofessionals of the Secretary. The contents of the analysis were used to establish the following categories: creation/implementation, operation, progress, difficulties, positive aspects which helped the implementation and management, improvements and proposals. The results show that the process of the Network creation was grounded in writings and international experiences and its implementation occurred because of the realization of workshops which aligned the conceptual idea to the health network. Its functioning happened because of the actions of the regulating authorities which are the macroregional Emergency Mobile Attention Service (SAMU) and the Center for Regulation Assistance in association with the Macro-regional Bi-party Inter-management Commission. The results point at difficulties, but also at positive aspects and advances. On the negative end are the financing model, the large territory, unequal micro-regions, micro-regions that dont followagreed procedures, the workers lack of preparation and their high turnover. On the positive end are the implementation of the network, the creation of the Committee, the regionalization of the Emergency Mobile Health Care, the classification of risk, improvements to access of services, commitment to implement processes, and the support from municipalities and from the State. As for advances, we highlight the better access to the services, a reduction in unexplained mortalities, improvement in resolution of services and a decentralization of medium and complex cases to other municipalities within the macro-region. We conclude that this is a complex and dynamic process that involves many different actors. This is an innovative and audacious action, which despite the difficulties has proved to be very positive.