Regionalização da assistência à saúde: eqüidade e integralidade na perspectiva de gestores Regionalization in health care: equity and universal access from the point of view of managers

RESUMO: Considerando que a organizacao da assistencia a saude, regionalizada e integrada em direcao a equidade e ao atendimento integral, e um processo politico e social e que sua implantacao nao depende apenas de normas legais, o objetivo deste estudo foi identificar barreiras que estao dificultando o processo de regionalizacao das acoes de saude na DIR XI — Estado de Sao Paulo, na perspectiva de gestores. Foram realizadas entrevistas com: gestor regional, chefia do pronto-socorro do Hospital Universitario, medicos da Central de Regulacao Medica e gestores municipais, totalizando 17 entrevistas, que foram gravadas, transcritas e organizadas de acordo com a abordagem metodologica do “Discurso do Sujeito Coletivo”. Os entrevistados apontaram diversas barreiras ao processo de regionalizacao da assistencia a saude, indicando a necessidade de se potencializar esforcos e medidas, mediante articulacao entre todos os envolvidos, visando assegurar a equidade, o acesso universal resolutivo e o desenvolvimento de um sistema integrado que objetive a producao social da saude. DESCRITORES: Prestacao de cuidados de saude — organizacao e administracao SUMMARY: Considering health assistance organization — regionalized and integrated so as to promote equity and universal assistance — as a social and political process and the fact that its implantation does not depend only on legal policies, the aim of this study was to identify barriers to the regionalization process of health actions at the DIR XI — Sao Paulo state from the managers perspective. Seventeen interviews were carried out with the regional manager, the head of the university hospital emergency service, physicians of the Medical Regulation Center and municipal managers. These interviews were recorded, transcribed and organized according to the methodological approach of the collective subject speech. The interviewees pointed out several barriers to the regionalization process of health assistance, highlighting the need for the increment of efforts and policies for promoting regionalization, by means of concerted actions of all involved aiming to guarantee equity, resolutive universal access and the development of an integrated system whose ultimate goal is the social promotion of health.