Avaliação da capacidade de coordenação do cuidado pela Atenção Primária à Saúde na pandemia da Covid-19 em Região de Fronteira

Abstract

The trajectory of the Unified Health System (SUS) in Brazil has achieved many results influenced by the transition of the epidemiological profile, geographic context and the socioeconomic characteristics of the different health regions. Among the challenges to be overcome, we highlight the integration of the Health Care Network (RAS), the guarantee of funding, the expansion of access and the reduction of territorial barriers. The strengthening of Primary Health Care (PHC) is a tool that can be used to achieve the integrative process. This work aims to evaluate the ability of PHC care coordination in a border region and its repercussions with RAS during the covid-19 pandemic. For this, a cross-sectional study was carried out, with a quantitative approach, through the collection of primary data from December 2020 to April 2021. 54 professionals participated in the research, including doctors and nurses from Basic Health Units (UBS) from Corumbá and Ladario. The assessment was measured using the Assessment Instrument for the Coordination of Health Care Networks for Primary Health Care (COPAS), prepared by Mendes (2010) and adapted to specific issues of the border territory, self-applied. In addition to the classification by general score, the evaluation was also carried out by each dimension, among them distributed in population, APS, support system, logistic system and governance system and correlated with the sociodemographic characteristics of professionals and variables such as Human Development Index (HDI) and PHC coverage. Among the participants, 72.2% were female, the most frequent age group was between 26 and 56 years, with a mean age of 39.96± 6.9 years (mean ± mean standard deviation). The overall COPAS score resulted in 64.09% with good condition of RAS coordination by PHC in the macro-region. The dimension of the COPAS questions that presented the lowest evaluation result was the Support System in Corumbá (54.70) and Logistic System in Ladário (61.25). The best result was APS both in Corumbá (68.74) and in Ladário (69.08). This study achieved the objective of evaluating the coordination of PHC in RAS in a border region during the covid-19 pandemic. It also sociodemographically characterized physicians and nurses, correlating HDI and population coverage in each municipality. Finally, it can contribute to the process of regionalization and integration, with more expressive characteristics in border health regions during the covid-19 pandemic. It can also serve as triggering questions for the elaboration of development strategies for the integration of HCN in the local health system, through the planning of more effective actions that strengthen the right and access to health in different territories.