Análise da efetividade da autorregulação formativa territorial mediada por tecnologia: um estudo de caso no estado do Espírito Santo

Abstract

In 2020, the Brazilian state of Espírito Santo began the implementation of territorial formative self-regulation, which consists of a model that integrates primary health care with specialized outpatient care. The objective of the study was to analyze the effectiveness of this model in terms of the interaction between the primary health care medical professional and the specialist medical professional, in order to understand whether there was a reduction in the average waiting time for consultations after its implementation. It was an exploratory, descriptive, and retrospective study carried out based on documentary research and analysis of the database of the State Department of Health of Espírito Santo. 2,402,652 requests for specialized care from users of the 1,005 Primary Health Care (PHC) units located in the 78 municipalities of the previously mentioned state were considered for consultations and specialized exams in the period from June 2020 to June 2023. In the first year of territorial formative self-regulation implementation, a total of 53,932 requests were answered, with a total of 4,348 completed, totaling 8.08% of process effectiveness; in the second year of the study, 98,738 requests were answered, and 19,848 were finalized, resulting in 20.10% effectiveness; finally, in the last year, 84,014 requests were answered, and 15,841 were completed, with 18.86% effectiveness. Regarding the average waiting time, the three regions of the referred state were analyzed, which allowed us to verify that in the period from 06/22/2020 to 06/21/2021, the South region had the lowest average waiting time, while in the period from 06/22/2022 to 06/21/2023, the Metropolitan region presented the longest waiting time. Considering the effectiveness of the model, the study analyses showed that it was possible to notice changes in practices in basic and specialized care, and the waiting time still constituted a major challenge. Therefore, knowing about these factors will allow the development of strategies based on the characteristics of each region, the adaptation of technologies to the reality of health professionals and, above all, greater proximity between them, reducing dependence on intermediaries.