Author / Partners:
PAHO/WHO and UFRN
Access, integrity, health care coordination, longitudinality
The municipalities of Curitiba, Rio de Janeiro, and some municipalities in the states of RN, PE, MA, and MG.
Metasynthesis and preparation of a matrix to analyze the proposed method and category of the theoretical model.
Results / Conclusions:
As a result of the assignment of doctors to areas that previously lacked medical care, there has been a reduction in the inequity of access; their longer stay at the location is required. Using a logic of adherence and a reduction of inequities, the study criticizes the incorporation of municipalities (sic). Satisfaction and acceptance by the population. Improvement in and increase of house calls by reorganizing medical appointments schedules to handle both the spontaneous as well as the repressed demand; an increase in the number of medical appointments as well as health care instruction and planning actions. Improvements in the relationship between medical professionals and users; Favoring the integrality of care, greater resolution capacity of PHC, while noting the lack of medication and equipment as elements that hinder effectiveness; Longitudinality due to the greater regular contribution of care provided to the population by teams of cooperating doctors. This generates effects that may increase health control of people with chronic diseases; A better quality was attained in referrals to a second level of health care, requests for complementary exams; Teamwork appraisal; Better resolution of health situations in the cases studied and strengthening of PHC.
Recommendations / Lessons Learned:
Ongoing studies and those already published have identified a potential for the work of cooperating doctors with the community, following practices they have learned and developed in their home country. Overall, it is not clear yet how the evident changes in the Brazilian municipalities’ health care model through closer personal health care contacts and attention to local needs by the cooperating doctors may or may not be sustainable after they leave. This is another aspect that needs to be given more attention in future studies in order to analyze the micro and macro political processes that interfere with the sustainability of the changes achieved with the performance of the cooperating doctors.