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The thinking and acting of health professionals on the coordination between the assistance levels of the health care network.

Mireilly Cristiany Moura Hemetério AraujoLygia Carmen de Moraes VanderleiMarina Ferreira de Medeiros MendesPaulo Germano de Frias
Published in: Ciencia & saude coletiva (2020)
The study aims to understand the thinking and acting of health professionals about the coordination between levels of care. Qualitative research from an international multicenter study Equity-LA II. Audios were retrieved from eleven interviews of doctors/nurses of two levels of care in Recife, 2014. A content analysis of the theoretical framework of coordination was performed in the light of the hermeneutic approach. Most professionals knew the duties of coordination, without identifying its execution. The primary care physician was not recognized as responsible for the clinic, nor for his role by the specialist physician, while the primary care physician resented it. Failures in the use/completion of reference/counter-reference mechanisms and organizational barriers emerged. The unavailability for the "conversation game" and "fusionality" was evidenced in the lack of recognition of authority in the authoritative character of the primary care physician by that of the specialized, feeling of less value for that and technicist and specialized posture in everyone's practice. The coordination in on professionals' view revealed the "there-to-be-understood" condition that needs to be launched in the "game of comprehension" to build dialogical practices focused on integral care.
Keyphrases
  • primary care
  • healthcare
  • palliative care
  • quality improvement
  • general practice
  • pain management
  • affordable care act
  • systematic review
  • mental health
  • chronic pain
  • global health
  • medical students