Acesso avançado na atenção primária à saúde como ferramenta de garantia do acesso no município de Camaçari

Abstract

Primary health care is considered one of the main gateways and the articulating axis of users' access to the Unified Health System and the Health Care Networks. Despite related advances, above all, in expanding the supply of services, this access still constitutes a challenge for the SUS. Advanced access is presented as an innovative tool, which makes it possible to reduce waiting times when scheduling appointments for primary health care, being associated with expanding access and reducing or eliminating queues. The present study has the general objective: To analyze how access to primary health care occurs in the Sanitary District of Costa de Camaçari, based on the implementation of advanced access. And as specific objectives: Characterize the organization and work dynamics of the primary health care teams, rom the implementation of advanced access in health units; Describe positive and negative points for guaranteeing access to primary health care, using advanced access. This is a qualitative study, with five primary health care units in a Health District in the municipality of Camaçari-BA as a scenario. Study participants were 24 health workers, including community health agents, nurses, receptionists, doctors and unit managers and 20 service users, totaling 44 participants. Data collection techniques were semi-structured interviews, document analysis and systematic observation. For data analysis, we used the content analysis technique, proposed by Bardin, and in a complementary way, the use of free access software, IRAMUTEQ, for similarity analysis. The discussion took place through three categories: Analysis of access to health services based on the implementation of advanced access; Team work dynamics with the new tool and Users' perception of access to PHC units. In a general context, health professionals and service users reported that advanced access brings benefits, especially in expanding access to spontaneous demand, as it allows users to have their demands resolved on the same day or through scheduling in short periods. However, the way the tool is implemented can generate an overload of work and increase bookings for the future, compromising the waiting time for routine care. On the other hand, some speeches brought the fragility in the integrality of the care, in view of the difficulty of access to complementary exams and specialized consultations, although they have facilitated the service with their primary care reference team. It is possible to conclude that advanced access brings several benefits, especially in expanding access to the preferred gateway of Health Care Networks, but that its implementation, by itself, is not capable of ensuring continuity of care and resolution