A Regionalização dos Serviços de Saúde em Goiás – 2004/2018: caracterização e perspectivas

Abstract

This study aims to discuss health regionalization and central health centers municipalities of the Plano Diretor de Regionalização da Saúde (PDR), 2004, in the State of Goiás. Also, to reflect about the public Brazilian health system, generally emphasizing Brazil’s regionalization, more specifically in the Goiás state. This research is justified because, given theoretical and methodological point of view, the planned and presented regionalization by the PDR (2004) presents issues relative to the principles and guidelines of the Unified Health System, not succeeding in the process of decentralization and regionalization in the States. The Goiás state promotes an assistance network of 18 regional units, where its medium and high complexity health activities should cluster in central/pole municipalities as compromised in the plan. So, we ask, within the 18 pole municipalities (PDR / 2014), do they provide an efficient polarization of medium and high complexity health services as proposed by the health regionalization plan? Or, do they exhibit weaknesses that end up reinforcing the polarization of Goiânia? Main aim: to evaluate the regionalization of medium and high complexity health services in the state of Goiás in 2004 and 2018. Specific aims: I. analyze the regionalization process in Sistema Único de Saúde (Unified Health System) after the Federal Constitution of 1988; II. evaluate the importance of geographical categories in the study of Brazilian public health; III. describe and analyze the regionalization criteria and the creation of health care networks as described by the PDR - GO/2004; IV. compare and analyze the medium and high complexity health services in their health regions and poles, as presented in 2004 and 2018; V. list medium and high complexity services that may or may not consolidate the 18 health regions and their municipalities in Goiás territory. The methodology used is mixed: qualitative and quantitative, with bibliographic and documentary bias. To apply it, a group of health care variables of medium and high complexity care was built, following the guidelines, objectives and definitions in their key concepts for the health region and the pole municipality (according to PDR) to present and evaluate 16 health regions and their respective regional hubs, as described in the 2004 document and then apply it to the 2018 data. Analysis results indicates that the health regionalization process is under construction and, in the Goiás state, the medium and high complexity care network is maintained at the state capital city, Goiânia: Central Health Region.