19 th Wonca World Conference - 2012 - Apresentação Dra. Catherine Moura
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Transcript of 19 th Wonca World Conference - 2012 - Apresentação Dra. Catherine Moura
Family Health Strategy in the National Health System in Brazil (SUS):
social, epidemiological and clinical context analysis for the cardiovascular risk intervention
19 th WONCAWORLD CONFERENCE19 – 23 May, 2010, Cancun - Mexico
Authors: Catherine M. F. Pinto (Gesaworld), Diego da Silveira, Roberson J. Kanamura, Juliana Vasconcelos, Gisele C. M. Sugai, Rosimeire R. Oliveira, Dalia
A. Nogueira, Angela M. B. de Oliveira, Rodrigo F. M. Leite (OS ACSC)
Speaker: Catherine M. F. [email protected]
Family Health Strategy: PHC
ESF/ACS/SB
ESF/ACS
ACSSEM ESF, ACS E ESB
0% 0 a 25%25 a 50%50 a 75%75 a 100%
Population : 10.940.311 inhabitants
•Area – 1.523 km²
•Population density– 7.113 inhabitants/km²
STATE OF SÃO PAULO
BRAZIL
CITY OF SÃO PAULO
City of São Paulo: South SideMunicipality of São Paulo, South side
• Population 2.486.258 inhabitants
• Largest population living in substandard residences (slum) -
21,4%
•Largest cluster of children under 10 years old -19%
•Second cluster in numbers of teenage pregnancies - 16,2%
•Fountainhead area with two Indian villages
• Highest rate of homicides in Sao Paulo (25,4 deaths/1000.00
inhabitants)
Management Contract: Public sector + Social Health Organizations
• Jointly responsible for managing health services
in many territories of the city of São Paulo
(hospitals, emergency services, primary
healthcare services and specialized healthcare
services)
Local scenarium – Partnership Model
In the management model adopted by the municipality is the partnership model with Social Health Organizations (OS), nonprofit organizations - that meets the requirements of municipal legislation for this purpose, which requires its rules and qualifications to manage health care services.
The management model determines territorial integration between the different levels of care.
The work is developed on the basis on the health needs of the population in a given area and observing the relationship between the different health care services.
The focus is the effectiveness of public health policies to expand access, resolution and quality of services and health actions.
The model is regulated and controlled by a “Management Agreement” outlining the commitments of partnership between the government (municipality or state) and the OS.
Cidade Ademar - Microregion
20 Primary Health Care services, with 11
services with the Family Health Strategy
implemented
06 Emergency services
01 Psychosocial support centers
01 Home Care
01 Specialist support team to family healthcare
strategy
02 Support services of diagnostic imaging
01 Dentistry specialized service
02 Medical specialized services
Hypertension and Diabetes Mellitus Cardiovascular Risk
Hypertension and Diabetes mellitus Cardiovascular Risk
Hypertension and Diabetes mellitus Cardiovascular Risk
Project: Cardiovascular Risk Guideline
An approach for the
identification of cardiovascular
risk parameters based on
epidemiological, clinical and
social factors.
Identification and classification
flowchart with cardiovascular risk
parameters based on social,
epidemiological and clinical studies
(Framingham scale).
Consider cardiovascular risk through programs of diagnosis and treatment of hypertension and diabetes mellitus using clinical, epidemiological and social data.
Cardiovascular Risk Guideline
Family Health Workers Team
Interface between population and health system
FAMILY SOCIAL RISK RATING Escore -6 a < 6 Low risk
Escore ≥ 6 a < 12 Moderate risk
Escore ≥ 12 a 18 High risk
Example of Therapeutic Plan
Expected Results
Conclusions
Greater identification of high risk cases influenced by the social factor
Provide a greater treatment for patients with cardiovascular risk, according to the level of social, epidemiological and clinical risks
Promote a holistic care of patients covering the social, epidemiological and clinical parameters
Organize the services (PHC) and the family health workers teams in order to increase the quality of the assistance to the population in this micro region of the city of São Paulo
Contribute for the family health development