PROGRAMA SAÚDE EM AÇÃO Strengthening the Health Management in the State of São Paulo
Brazilian Public Health System ( Sistema Único de Saúde) "Health is everyone's right and duty of the State, guaranteed through social and economic policies aimed at reducing the risk of disease and other health problems and the universal and equal access to actions and services for its promotion, protection and recovery (Brazilian Federal Constitution of 1988). SUS Pillares: UNIVERSALITY Regionalization Hierarchy Descentralization Social Control EQUITY INTEGRALITY
Population: 200,4 million Area: 8,514,876.60km2 Population: 41,692,688 million Area: 248,196km2
Demographic growth and Epidemiological Profile COMUNICABLE DISEASES NON- COMUNICABLE DISEASES Triple burden of diseases EXTERN CAUSES a transição demográfica 1980 2000 2010 2030 10% elderly population BRASIL 15% elderly population 20 MILLIONS 2005 a 2030 more than 40 MILLIONS FONTE: IBGE (2014)
median age of the population will jump from 20 to 40 years from 1980 to 2030 Hospital admissions/100.000 inhabitants by age group: 60 years or older: 11,53 15 to 59 years: 5,07 Younger than 15 years: 4,02 fewer children to be educated and more erderlies to be cared for (DATASUS 2011)
FRAGMENTED SYSTEM X HEALTH CARE NETWORK HIERARCHYC AND FRAGMENTED SYSTEM POLIARQUIC HEALTH CARE NETWORK HIGH COMPLEXITY MEDIUM COMPLEXITY PRIMARY CARE LOW COMPLEXITY FONTE: MENDES (2009)
SUS Regionalization Process and the Health Care Network MAPA SAÚDE, PACTO PELA SAÚDE RRAS RENAME RENASES REDES TEMÁTICAS COAP 2006-10 2011 2011-12 2011-14
Portaria GM/MS 399/06 SUS Regionalization Process and the Health Care Network State of São Paulo- Brasil
AS REDES DE ATENÇÃO À SAÚDE desafios avanços
SÃO PAULO INFRAESTRUCTURE HOSPITAIS 93ESTADUAIS 55 40 AMES FARMÁCIAS AMBULATORIAIS DE ALTO CUSTO
ASSISTÊNCIA Procedimentos hospitalares e ambulatoriais do SUS - por local de ocorrência SP/Brasil Período:2016 GRUPOS/SUBGRUPOS PROCEDIMENTO SÃO PAULO BRASIL PERCENTUAL SP/BRASIL SÃO PAULO BRASIL PERCENTUAL SP/BRASIL Total internações Alta Complexidade (SIH) 178.825 715.139 25,01 834 bi 3.5 tri 23,72 Total Qtd.Aprovada Alta Complexidade (SIA) 6.988.879 24.910.789 28,06 985 bi 3.4 tri 28,79 Internações Tratamento em Oncologia (Clinico) SIH 75.729 303.737 24,93 70. bi 299 bi 23,54 Cirurgia em Oncologia (SIH) 33.451 133.922 24,98 114 bi 459 bi 24,95 Transplantes de Órgãos 5.676 17.418 32,59 179 bi 509 bi 35,13 Cirurgia do aparelho circulatório 80.520 282.598 28,49 404 bi 1.5 tri 25,37 Radioterapia 2.570.216 10.419.050 24,67 98 bi 401. bi 24,45 Quimioterapia 763.564 2.982.771 25,60 420 bi 1.5 tri 26,52 Pet-CT 6.399 13.934 45,92 13 bi 29 bi 45,89 Tomografia 1.467.730 4.327.778 33,91 183 bi 527 bi 34,83 Ressonância Magnética 344.520 1.071.712 32,15 92 bi 290 bi 32,06 TRS 3.282.343 14.364.324 22,85 648 bi 2.7 tri 23,23 Fonte: Ministério da Saúde Sistema de Informações hospitalares e ambulatoriais do SUS (SIH/SUS e SAI/SUS)
SUS- São Paulo Challenges Financial insufficiency Dislocation between the attention levels Lack of guidelines Lack of standardization of the work process Patient uninformed Unengaged professional Inefficiency of the system, besides the high number of appointments and procedures
PROGRAMA SAÚDE EM AÇÃO RMC VALE DO JURUMIRIM LITORAL NORTE ITAPEVA VALE DO RIBEIRA
Objectives of the Program Territorialization Qualified professional Paients registration Electronic medical records Unidade Básica de Saúde Model Health Care pathways Acess regulation Deliverable Health Services Informatization Strenghtening bonds
PROGRAMA SAÚDE EM AÇÃO Consultancy studies in development 2015 2016 2017 2018 2019 Diagnose an evalluation of São Paulo Health Care Networks UBS current costs Development of Health Care Pathways Hypertension, Diabetes, Mental Health, Child, Elderly and Pregnant/ Puerperum Definition of Professional Competencies in primary care Medical transportation plan Stategic plan for countinuing education Improvement of the regulatory model Proposition of HR retention strategies Development and implementation of the SES training program for professionals in the central and regional area
Unidade Básica de Saúde (Primary health care center)
Regional Hospitals
SUS- São Paulo Challenges AAAAA Renal replacement therapy Oncology Cardiology Child Cardiology Orthopedics Health Promotion and Prevention Programs Mental Health Non comunicable diseases
SUS- São Paulo Challenges Specific data base Governance of the Public Health System Institutional support to SES/SP Integrative Care Partnership Center For Integrated Care Edinburgh University and West Wales University Governmental regulation in health
PROGRAMA SAÚDE EM AÇÃO OBRIGADO! Fátima Bombarda Coordenadora de Redes UCP/SES-SP E-mail: fbombard@saude.sp.gov.br Nelson Yatsuda Coordenadoria de Regiões de Saúde- Assistente do Coordenador E-mail: nyatsuda@saude.sp.gov.br