Proposta de estruturação, organização do fluxo e hierarquização da rede de reabilitação física de um Departamento Regional de Saúde do estado de São Paulo [thesis]

Daniel Martins Coelho
COELHO, Daniel Martins. Structuring and organization proposal of the flow and hierarchy of the physical rehabilitation network of the state of São Paulo's Regional Health Department 2019. 135f Tese (Doutorado em Ciências da Saúde) -Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, 2019. The Brazilian Unified Health System is one of the largest public health systems in the world. It was created in 1988 and althougt that the disabled person does not have a
more » ... s not have a structured rehabilitation network, presenting specific initiatives only in recent years. The objective of this study was to propose the structuring of a care network for people with physical disabilities among the 26 cities of the 13th Regional Health Department in the state of São Paulo interior. Materials and Methods: This is an exploratory and descriptive research that developed its work through administrative and technical meetings among the 5 Rehabilitation Centers accredited in this region. The technical work was carried out by health professionals selected by representatives of CERs to define specific rehabilitation protocols and insertion criteria for the different levels of complexity. The criteria were evaluated by rehabilitation professionals to determine if they correctly identified the level of complexity of fictitious clinical cases, without knowledge of the criteria and after the presentation of the criteria. A questionnaire was sent to the municipal rehabilitation services to identify the service profile, repressed demand and available human resources in the network. The data were analyzed in a quantitative and related way. Results: Specific objectives, eligibility criteria and rehabilitation protocols were developed for the secondary and tertiary levels of rehabilitation. The analysis of the criteria by the professionals in the area of adult neurology identified that 71% of the answers selected the correct level of attention that the patients fit and maintained the choice even after the presentation of the criteria of this area. In the area of children's neurology, 73% of the correct responses were identified and maintained after the criteria were presented. The evaluation of the basic rehabilitation network identified that all the municipalities presented physical therapists in their professional staff, being fault in professionals of other areas. A waiting list of 7479 unanswered requests was identified, the main demand being for orthopedics and traumatology with 78.9%, followed by adult neurology with 9.2% of the cases. A network flow proposal was carried out with a specific regulation system for rehabilitation that controlled the references and counter-references of the network. Conclusion: The development of a rehabilitation network is possible to be carried out with the active action of the members of this network with definition of the specificities of each service and well established criteria.
doi:10.11606/t.17.2020.tde-11022020-151226 fatcat:jjqzesacefa6tkj4u34lxbqsxq