Notes for the study on health systems: multifaceted analysis and tracer indicators

• Published in: Revista de saúde pública Vol. 54; p. 102
• Main Authors: Onocko-Campos, Rosana Teresa, Campos, Gastão Wagner de Sousa, Amaral, Carlos Eduardo Menezes, Tanaka, Oswaldo Yoshimi
• Format: Journal Article
• Language: English; Portuguese
• Published: Faculdade de Saúde Pública da Universidade de São Paulo 01-01-2020; Universidade de São Paulo
• Subjects: Health Policy & Services; Original; Outcome and Process Evaluation, Health Care; Primary Health Care; Secondary Health Care; Triangulation of Methods; Avaliação de Processos e Resultados em Cuidados de Saúde; Triangulação de Métodos; Triangulation of Methods; Atenção Secundária à Saúde; Secondary Health Care; Primary Health Care; Atenção Primária à Saúde; Outcome and Process Evaluation, Health Care
• ISSN: 0034-8910; 1518-8787; 1518-8787
• DOI: 10.11606/s1518-8787.2020054002055

OBJECTIVETo present the methodological approach used in a research that analyzed the use and performance of specialized health care, from primary care access, in four major Brazilian cities: Fortaleza (CE), Campinas (SP), São Paulo (SP) and Porto Alegre (RS). METHODSPresentation and discussion of the quantitative-qualitative components of the proposed research strategy. RESULTSFour tracing conditions were studied: systemic arterial hypertension, high-risk pregnancy, breast cancer and severe mental disorder. For each health condition, indicators were constructed based on health information systems data, pointing out frequencies, temporal trends and local differences. This initial contextualization was enriched with a descriptive-qualitative study of the performance of each municipal health service network. Next, a cross-sectional study was conducted through a survey of 7,053 users of specialized services for each health condition. Finally, in-depth interviews were conducted with key actors to complement selected operational aspects of each municipality's network. The results of all these data sources were triangulated, allowing us to explore the variability of SUS implementations in different regional scenarios. CONCLUSIONSThe multifaceted analytical model presented allows us to understand relevant aspects of the Unified Health System performance, paying attention to the singularities, heterogeneities and inequalities that characterize its implementation in Brazil and emphasizing the performance of local networks for the addressed health conditions.