Bioética do acesso a serviços públicos de saúde na regional metropolitana de saúde do Paraná

The goals of the present dissertation are to identify and analyze the characteristics of the decentralization of Brazilian public health care policies, through an accurate observation of access to public health care services in the Metropolitan Regional of the Health Secretariat of Parana between years 2000 and 2008, especially with the paradigmatic management shift, leaving the basic operational norms of health care for the Health Pact, consolidation of the National Health Care System – SUS, through Ordinance 399 GM of February 22nd 2006.This is a research based on secondary data, obtained from the management instances of the National Health Care System, the Institute of Economic and Social Development of Parana - IPARDES and academic studies on the same subject or the same region. Health conditions and attention to health and disease are more unfavorable the further are the municipalities in relation to the capital. The relative demand for health care services beyond the municipalities increases in direct proportion to this distance, with the exception of three municipalities aggregated to the metropolitan area of Curitiba, characterizing local and regional access restrictions due to action or omission of the health care system itself, which accentuates the unfair inequalities, despite the fundamental principles of universality, comprehensiveness and equity.