| Autor: |
Cecilio LC; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil., Carapinheiro G; Instituto Superior de Ciências do Trabalho e da Empresa, Instituto Universitário de Lisboa, Lisboa, Portugal., Andreazza R; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil., Souza AL; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil., Andrade Mda G; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil., Santiago SM; Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brasil., Meneses CS; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil., Reis DO; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil., Araújo EC; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil., Pinto NR; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil., Spedo SM; Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil. |
| Abstrakt: |
This study aimed to characterize which regulatory logics (other than government regulation) result in healthcare output, using a two-stage qualitative study in two municipalities in the ABCD Paulista region in São Paulo State, Brazil. The first stage included interviews with strategic actors (managers and policymakers) and key health professionals. The second phase collected life histories from 18 individuals with high health-services utilization rates. An analysis of the researchers' involvement in the field allowed a better understanding of the narratives. Four regulatory systems were characterized (governmental, professional, clientelistic, and lay), indicating that regulation is a field in constant dispute, a social production. Users' action produces healthcare maps that reveal the existence of other possible health system arrangements, calling on us to test shared management of healthcare between health teams and users as a promising path to the urgent need to reinvent health. |
