atenção primaria a sus

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Ensaio histórico-conceitual sobre a Atenção
Primária à Saúde: desafios para a organização de serviços básicos e da Estratégia Saúde da Família em centros urbanos no Brasil
A historical and conceptual model for Primary
Health Care: challenges for the organization of primary care and the Family Health Strategy in large Brazilian cities

Eleonor Minho Conill

1

Abstract
Departamento de Saúde
Pública, Universidade de Santa Catarina,
Florianópolis, Brasil.

1

Correspondência
E. M. Conill
Departamento de Saúde
Pública, Universidade
Federal de Santa Catarina.
Rua Vento Sul 306,
Florianópolis, SC
88063-070, Brasil. [e-mail] Introdução

This paper focuses on the experience with Primary Health Care as a strategy for reorganizing the health care model, based on reforms in this direction and their implementation in the Brazilian case. The article identifies a shift in the discourse concerning health sector reforms, with a return to emphasis on primary care and integration of services. The Brazilian context demands reflection on the possibilities for synergy between this strategy and other social policies and the factors needed to ensure adequate performance. Evaluation research has suggested that primary care activities are slightly superior as compared to traditional health care units, despite persistent difficulties in access, physical infrastructure, team formation, management, and organization of the network. These difficulties correlate with a low level of public financing, persistent segmentation of the system, and weak integration of primary care services with other levels of care. From the technical perspective, a reasonable target is to guarantee the strategy’s continuity with the necessary adjustments, conditioned by the dynamics of the health care technical models involved in the dispute.

Apesar da enorme influência da medicina hospitalar, a figura do clínico geral ou do médico