Name: Cynthia Moura Louzada Farias
Type: PhD thesis
Publication date: 09/10/2019
Advisor:

Name Rolesort ascending
Edson Theodoro dos Santos Neto Advisor *

Examining board:

Name Rolesort ascending
Raquel Baroni de Carvalho Internal Examiner *
Adauto Emmerich Oliveira Internal Examiner *
Lígia Giovanella External Examiner *
Ana Rosa Murad Szpilman External Examiner *
Edson Theodoro dos Santos Neto Advisor *

Summary: Introduction: The non-attendance of users to appointments and procedures scheduled
in the SUS has compromised the excessive demand for specialized actions. Access to
health services is still disorderly and requires reorientation. Faced with the need to
rationalize resources and provide better access to different levels of care complexity with
better resource use and economy of scale, it is necessary to organize a health system at
the regional level that considers the different variables, such as user flow , also
influenced by the socioeconomic and contextual characteristics of the different
municipalities. Objectives: This study aims to diagnose and analyze the main causes of
absenteeism in secundare health care networks in the Metropolitan Health Region of the
state of Espírito Santo (RSM-ES), Brazil. Methods: This is a mixed study, developed in
four stages, which included sequentially a metasynthesis, a study of secondary data, a
cross-sectional study and a case-control study carried out in the 20 municipalities that
compose (RSM-ES). As sources, the patients' scheduling data was used in the System
of Integrad Regulation (SISREG), from January to December 2015, which estimated the
prevalence of absenteeism. Telephone interviews (2.095) and face-to-face interviews
(40) with users were used to collect data. Quantitative data were tabulated and
statistically analyzed. Results: The results identifed the determinants of absenteeism in
specialized consultations and examinations, to facilitate actions and strategies that
prioritize the organization of the process and performance of care regulation, leading it
to fulfill its role of organizing flows, manage and prioritize access, thus guaranteeing the
principle of integrality of SUS. Conclusion: more precise interventions can solve the
problem in its origin, such as the need to update the assistance parameters, to
strengthen regulation, so that the professionals that compose the health network and
those who exercise the regulatory function can fulfill the precepts SUS, and thus ensure
integrality in the health care of the population.

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