Multifactoriality of care regulation for the territorial and regionalization sustainability

Abstract

Regionalization is a logical, powerful, and indispensable governance process in the healthcare policy scenario. Faced with the challenges of a solidarity-based regionalization that enables universal access, equity, and comprehensive care, the pioneering Interstate Health Network of the São Francisco Valley, in the region between the states of Pernambuco and Bahia (PEBA Network), was implemented. The study aimed to analyze the complex managerial relationship involving public and private agents in care coordination. The approach was qualitative, focusing on the regionalization process of the PEBA Network through care regulation, from the perspective of managers, service professionals, and users. The analysis of the supply-production-waiting list association reaches a consensus: the qualification of clinical management, referral process, and the need for organization and communication are essential to ensure timely access. Otherwise, there are direct effects on absenteeism, impacting the increase of queues, requiring a systemic and multifactorial approach to organize the regulatory process. The need for organizational arrangements involving all actors in the formulation and development of public health policies becomes evident to overcome barriers to care coordination and comprehensiveness in health.