Política pública de saúde: os elos das redes de produção da linha de cuidado ao trauma ortopédico no município de Santarém/Pa

Abstract

Brazilian Public Health, through the Unified Health System (SUS), encompasses primary care, of medium and high complexity, urgency and emergency services, among others, based on the principles of universality, equity and integrality. Morbidity and mortality due to external causes of accidents and violence represent impacts on the public health of orthopedic trauma at the national and local levels. This study aimed to evaluate the production of health care services of the Trauma Care Line in the urgency and emergency network and its regulatory flows from the Municipal Hospital of Santarém, in the period from 2019 to 2021. Through a study of quantitative, exploratory approach and descriptive presentation, this research sought answers to the guiding question: Does the production of services in orthopedic health care of the public health network of the municipality of Santarém/PA enable the formation of links in the Trauma Care Line? The methodological path included the collection of secondary data, originating from the hospitalization in the Municipal Hospital of Santarém (HMS) for ICD of Transport Accidents and Falls, with the support of additional information from the flow in the RAS, next to the Municipal Ambulatory of Specialties and Municipal Health Secretariat (Semsa). The focus of health evaluation in this dissertation is based on the Donabedian Triad (Structure, Process, Result) whose method is widely referenced in Brazilian public health policy. The conclusion reached in this research was evidence of non-compliance of some care and administrative processes in the Municipal Hospital of Santarém, observed, above all, in inconsistencies that prevented the qualification of the information of the provision of services in the perspective of the Trauma Care Line, as well as the perception of low performance in the quality of the conditions of a hospitalization to the patient generating a production of humanized care, based on the length of stay in both observation and clinical beds and the regulation/transfer of the patient to another health facility. Other unfavorable issues identified are related to the structural issue of the Municipal Specialty Outpatient Clinic and to the information on the scheduling of outpatient requests by the Municipal Health Department, since not all appointments allowed the identification of the effectiveness of the service.