O processo de trabalho na alta complexidade no contexto das políticas de controle do câncer no Brasil

Abstract

This dissertation examines at which level the national policies for cancer control in Brazil organize the work process in oncological high complexity, through human resources in health (HRH) - clinical oncologists, radiotherapists and medical physicists - bound to the State oncological high complexity network, from the definitions established by the SAS/MS Order # 741/2005. It is an exploratory case study, which brings a brief overview of Oncology in the historical context of health. The three ministerial resolutions directed to the control of cancer in the country are presented and, through technical report and theoretical referential based on the three dimensions that permeate the HRH proposed by Pierantoni (structural, management and regulatory), exemplify how the dissemination of the cancer control policies in the country and the first State sketches of the oncological high complexity network came to be. Some situations encountered indicate that while some of the instruments in the area of oncology are still little used by the managers in their planning and management process, others need to be improved. The case study was on the Oncological Care Network in Rio de Janeiro 2008, composed of federal, state, municipal, university and philanthropic hospitals, all under municipal management. In terms of analysis, three elements stand out: the characterization of these health services, the parameters of care coverage and ambulatorial production of chemotherapy and radiotherapy and the number and workload hours of the human resources in health. The National Registry of Health Facilities of the SUS Information Department (DATASUS) and the Ambulatorial Information System are used as data sources, as they represent a data bank that may contribute to the management of the oncological area, this way widening its utility to the SUS. Finally, the findings allow a reflection from both the perspectives of work management and management education in health, on how is the oncological cancer care configuring itself and what are the actual limits and possibilities to have the dimensioning of the studied professional categories included in the ministerial normative instruments.