Healthcare network: systemic integration from the perspective of macromanagement

Abstract

This article analyzes the systemic integration of health care in the breast cancer care line, in the context of the regionalization of health in the state of Bahia, under the perspective of macrogestión. Retrospective cross-sectional study, exploratory and descriptive, using the quali-quantitative and referential approach of the public policy network. The techniques of documentary analysis, data extraction of information systems, semi-structured interviews with 141 participants in the data collection were used. It was chosen as analytical categories: Institutional design of the oncology network; Primary Health Care as gateway to the network; support systems and logistics systems. The results showed that the standards, although necessary, are not sufficient in themselves to guarantee systemic integration; the design of health care networks has followed the logic of structuring by supply, becoming denser in large population centers, generating care vacancies; the population's access to services that are not complementary to the SUS and / or high technological density prevails, evidencing the hegemony of the medical-centered and privatized model; mechanisms of regulation of access and management of information systems still occur in an incipient way, with little and / or sparse interaction between them.