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 was no longer sufficient to forward the request of the qualifying hospital describing its structure and capabilities to perform this highly complex care. But we must not neglect to mention that the installation of new equipment by the state government may intensify competition between municipalities in a specific region, especially because they constitute the most visible way of obtaining political advantages for the municipalities which establish them.
We noted evident conflicts between municipalities in the region. On the other hand, there is still difficulty, from all elements of the system, in prioritizing the adoption of management tools for clinical practice and regulation. A set of institutions has been organized into networks to manage this model. There can be no SUS regionalization without the presence of all municipalities in the region and without the state. For this reason, the study of the Thematic Oncology Network is relevant for public health and health management.
In other words, if the process of municipalizing the health system in the last few decades has strengthened political autonomy in the cities, the proposal to rationalize the services structure by regionalization follows a more administrative logic. It can be seen that the organization of the networks should indicate these levels. INCA continues as a technical advisory body of the Ministry deceeto Health to advise on the accreditation of services.
Regional consciousness and identity, or regionality, involves decreot identifying themselves with their region, both inside and outside of it.
In Elias we can see that there are ways of reversing this situation: Changed the focus of habilitation, bringing the need for regional discussions and elaboration of care plans that consider the network where the establishment to be enabled is inserted – Regional Cancer Attention Plan. Open in a separate window. The managers needed to 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.
Abstract In the current context of epidemiological transition, demographic changes, changes in consumption and lifestyle habits, and pressure on care costs and organized health systems for acute conditions, the Integrated Care Model by Shortell has become a conceptual reference in the search for new methods to manage chronic conditions by focusing on the health conditions 201 a given population that must be addressed by a set of institutions organized into networks.
Develop studies and actions for pain relief policy in oncology. The last Ministerial Order,had as a significant motivator the publication ed Law The Portaria changed the focus of habilitation, leading to the need for regional discussions and the elaboration of care plans dereto considered the network that included the establishment to be enabled. It is necessary to evaluate the practices adopted from these criteria and determine whether they were adopted to complete this analysis.
The barriers that often hinder the process of regionalization are linked to tensions and conflicts between objectives, integration and political factors. It could be thought that this regional xenophobia is encouraged by the technical-administrative parameters adopted by the health care managers which, either concentrate more on supply rather than on demand, or only consider demand in their own municipality; or only consider the demand of those dependent on the SUS.
This legal set aims to reduce the inequalities imposed by the territory where the individual lives, ensuring citizens’ access to necessary actions and health services close to where they live 8.
National Center for Biotechnology InformationU. In this case, it falls to those coordinating the process of governance to define the “rules of the game” so that the players can “play”. This study aims to evaluate the evolution of the care model for cancer patients in SUS based on the integrated care model.
Organization of the cancer network in SUS: evolution of the care model
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.
Recognizes oncology as a highly complex network: Deadlocks in the process of health d 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”. To do this, the hospital can offer the structure and services needed for every step of the care line, focus on care eecreto requires more expensive and complex technologies and establish referral and reference flows with other levels of care.
The Greater ABC area has an average of 1. The role of the state is decreeto only to open a social organization in the region for medium and complex treatment but also to support the municipalities financially, as it is they who, in fact, manage the health care systems in a region.
Therefore, regulation is aimed at providing care alternatives more appropriate to the needs of the citizen, in an even, decreo, timely and qualified fashion. Finally, to guarantee centralized regulation with maintaining the autonomy of local governments.
According to the statements we heard, some of the expected effects would be: The deadlocks surrounding the regionalization process lie in economic interests, political deadlocks, competition between municipalities and the state and governance. Political deadlocks are at deecreto core of issues in the region. Isolated chemotherapy and radiotherapy services that could continue to function under specific conditions but linked to a UNACON or CACON with predicted technical cooperation and joint planning of treatments.
In the past 15 years, cancer has gone from the third- to second-leading cause of death in the state and has shown a gradual increase in the number of new cases. dw
Organization of the cancer network in SUS: evolution of the care model
Prepared by the authors 20111 on Shortell, 2. During this period, it is possible to observe a progressive orientation towards the integral and deecreto care of patients with cancer. 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.
The importance of regulation as a tool to improve the functioning of institutions within the health care sector needs to be recognized, given its role in minimizing the opportunism of the agents and the difficulties inherent in rationality as regards the functioning of the health care system.
Therefore, a regionalized and integrated health care system is inconceivable without the presence of the state, as it is the state which is responsible for coordinating the municipalities. We can see, in the case of the Greater ABC area, that this regulatory role is not so clearly viewed on the part of health care professionals.
We want to highlight that regional identity is a premise for thinking about the region Gil and col. The challenge is the transformation of an acute case-focused system with an emphasis on disease and individual planned care whose primary goal is to fill hospital beds and whose organization is departmentalized and focused on the functioning of institutions in isolation.
Installed in a story building were beds for hospitalization, 11 operating rooms, armchairs for outpatient chemotherapy infusion, 63 surgeries and 6 linear accelerators. Definition of parameters for more detailed planning and evaluation of the network and based on the INCA 0211 of number of new cases per dcreto minimum number of production per treatment modality.
We can see that the region needs to fecreto and mature regional cooperation so that regionalization can occur, if not, the current model in its current form will persist: We can see that political-administrative deadlocks which make the regionalization process more difficult, related to disagreements between the authority and responsibility, to tensions and to conflicts between objectives and horizontal and vertical integration. One, carrying out a prior evaluation of the health care and planning and programming needs, which includes epidemiological aspects, care resources available and access conditions to the units in question.
The regionalization process exposes one of the facets of the tension which manifests itself in the defence of federal entities, due to their marked socio-political differences.
The latter is concerned with coordination, relationships and leadership based on 7058 social players, something which does not occur in the Greater ABC area due to the “power games” existing between them, meaning there is great difficulty in its operation, as one dr will not cede its interests to others.
These activities were structured to provide comprehensive care to adult cancer patients at all stages of treatment and for all of their needs, including palliative care when necessary And, finally, to improve the quality of public control of the health care system.