trabs

2307

Health care networks: contextualizing the debate

Rosana Kuschnir 1
Adolfo Horácio Chorny 2

1

Fundação Oswaldo Cruz.
Av. Leopoldo Bulhões 1.480/ sala 319, Manguinhos.
21041-210 Rio de Janeiro
RJ. [e-mail]
2
Departamento de
Administração e
Planejamento em Saúde,
Escola Nacional de Saúde
Pública, Fundação Oswaldo
Cruz.

Abstract The proposal of organization in health services networks has been included in the broad field of integrated health care, a general denomination which includes a wide range of interventions varying in objectives and scope, which have in common the pursuit of integration strategies and tools. Among the main experiences in the field are the American integrated delivery systems and the traditional regionalized networks of the national health systems, especially after the introduction of new cooperation strategies. However, while strategies and organizational arrangements might be similar, context is central to debate. Not considering differences concerning health systems nature may turn it difficult to grasp main distinctions in policy making which are responsible for possibilities and limitations of adopting integration strategies and tools. This article aims to look for references in the literature and international experience that might contribute to the debate on health networks building in the Brazilian Unified Health System (SUS). It discusses context regarding the creation of integrated health services networks in two cases, the
British National Health Service and the American Health System, focusing specifically on the health services organization component.
Key words Health services network, Regionalization, Integrated systems, Health services organization

Resumo A proposta de organização de redes de atenção à saúde tem sido incluída no grande campo do “cuidado integrado”, denominação genérica que agrupa intervenções que variam muito em objetivos e escopo, tendo em comum