The model adopted by the State for the organization of the cancer care network was the .. Decreto n° de 28 de junho de Brasília. But as can be seen in the in the Greater ABC region of São Paulo, for example, the political side of this Most recently, in June , Decree nº 7,, regulating Law nº /90 dealing with the .. Decreto nº , de 28 de junho de
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It is the only SES hospital dedicated to the treatment d adult patients with cancer all types in the SUS, with two years of activity.
Organization of the cancer network in SUS: evolution of the care model
In the proposed model for management of chronic conditions, the focus is on maintaining health and preventing disease in a defined population and the health conditions of this population. It is also within these territories that Thematic Networks must be organized e.
Define regional needs for palliative care in an articulated way with other ve areas. Definition of the care line and technical criteria for the operation 7580 evaluation of public and private services that work at different levels of cancer care; definition of a CACON regional reference.
Another, that public responsibility be formally undertaken, with the participation and involvement of civil society and of the diverse players who make up the health care system in the territory. It is necessary to evaluate the practices adopted from these criteria and determine whether they were adopted to complete this analysis.
Finally, defining the interfaces of the strategy for regulating health care as a process of planning, programming and other control and evaluation instruments Ibanhes and col. I PhD in Public Health. It established parameters for the sizing of services according to the number of estimated new cases and INCA.
The managers needed drcreto describe how organization and responsibility would be allotted at all levels of care, considering all of the components of the network of care for people with chronic diseases in the thematic axis of cancer [i. A region may have contain economically powerful municipalities, but that does not mean that they alone have the capacity to provide all health care services.
Each RRAS must have a sufficient capacity for basic care, medium-complexity services and some high-complexity services. From the perspective decrrto health services and systems planning, the cancer care line involves all levels in different services and stages, with multiprofessional involvement and multiple medical specialties, in a non-linear process. There are divergences and conflicts of interest between the municipalities themselves, and between them and the State.
It also reduces extremely high social costs, imposed by the long journeys SUS users outside of these regions have to make. The role of the state has become fundamentally important for municipalities which do not have sufficient autonomy to become independent of state government. They are seen as “aliens” or foreigners who affect monthly and yearly health care indicators.
For Guerreiro and Branco regionalization can positively impact on equality, as it disregards resources exclusively coordinated in a few hubs in the state and thus determines increased satisfaction on the part of the users.
The following year, these 57 ERSAs were increased to Also according to the state plan, the CGR should qualify the regionalization process and guarantee cooperative actions between secreto managers of each health care region, with the participation of all municipalities of which it is composed, and with the State representation.
According to the statements we heard, some of the expected effects would be: According to Eliasregionalization of the health care system is inconceivable without effective state participation.
Planning and design to implement colorectal cancer screening. The State assumed the leading role in the organization of a thematic network, and the experts were able to contribute to the definition of public policies.
The last Ministerial Order,had as a significant motivator the publication of Law The abolition of the DIR II, which had been responsible for the Greater ABC region, and for its transfer to the state capital, now in the form of the DRS I, seemed to be a step backwards in the search for more efficacy in health care activities in the Greater ABC area and, consequently, for improvements in the concept of the health care region, as recommended by the SUS.
Cancer Care Plan Perspective: In this way, the CGR is configured as decretl permanent space of agreement, co-management and decision making, through the identifying and defining priorities and agreeing solutions for the organization of an integrated, problem solving regional network of health care actions and services Brasil, A regionalized system should still be capable dr coordinating the various fields of health care in a specific territory in a coordinated way, aiming to ensure the comprehensiveness of the actions and of the access to health care services.
Gerschman affirms that this is a recurring issue in some areas of health due to the municipalization of the SUS having appeared as an option for decentralizing health care activities at the beginning of the s. In the English model of Regionalised and Hierarchical Networks, there is a network of regions based on large territories with primary health centers, secondary schools and teaching hospitals that ensure access to comprehensive care and seek self-sufficiency in health resources at all levels and in smaller territorial subdivisions.
Hospitals must stop acting alone and must establish alliances with other hospitals and clinics in the community while developing a specific strategy for primary care. For the following period State Health Plan tocancer mortality was ranked second with a growing trend, accounting for Given that coordination between the municipalities themselves is essential, the state government needs to take on coordination of the SUS regionalization process, seeking to propose general directives and norms, through agreements in the Inter-managerial Bipartite Commission – CIBin coordinating the organization and updating of the Regional Plan – Plano Diretor Regional PDR in a region.
Each RRAS consists of health services of different technological densities and of support systems to ensure the integrality of the services. Finally, to guarantee centralized regulation with maintaining the autonomy of local governments.
Together with the DRSs, the CGRs are responsible for altering directives, objectives, aims and indicators, according to the reality and peculiarities of the local areas.
Judging from the statement of an interviewee from the Board of Health, Rio Grande da Serra, “on rare occasions, the municipalities act cooperatively with regards human, technological and financial resources”. It is known that both decentralization and regionalization of health care are alternatives recommended to improve the administrative efficiency and participation of the services, with the emphasis on local participation and autonomy, together with the redistribution of power and reduction of loco-regional tensions.
There is no question that there are municipalities, in a given region, which are more dependent on state resources than others. As an area classified within the High Complexity of SUS, in which the manager requires compliance with minimum parameters for the service provider, Ministerial Ordinances are important drivers of the establishment of care models and the implementation of management culture.
RESULTS In Brazil, cancer ceased to be a disease treated only in medical offices and became a public health problem in with the Anticancer First Plan and the inauguration of the Radium Institute in Belo Horizonte, a private entity and the first center to fight cancer in the country.
Organization of the cancer network in SUS: evolution of the care model
The “smaller” municipalities do not decfeto feel included in the negotiated agreements, as they question allocation of resources concentrated on their “richer” counterparts. The workforce consisted of 3, employees, of whom were physicians and were service providers from third-party companies in the areas of concierge, security, reception, nutrition, hygiene and cleaning, IT and building maintenance.
The examples of projects presented in this article reinforce the idea that specialized hospitals should participate more actively in the discussions and elaboration of public health policies and, in this way, may participate in health care networks in a role that goes beyond the care of acute chronic conditions, contributing to the development of clinical management technologies and alternative defreto.
The number of oncological surgeries, chemotherapy and radiotherapy procedures increased to decrsto. Installed in a story building were beds for hospitalization, 11 operating rooms, armchairs for outpatient chemotherapy infusion, 63 surgeries and 6 linear accelerators. We can see decrreto the region needs to advance and mature regional cooperation so that regionalization can occur, if not, the current model in its current form will persist: Regionalization of the public health system aims to encourage and enhance efforts and measures involving the organization of local and regional public health, through coordinating all those involved.