Eunice Isabel do Nascimento Carrapiço, Ana Rita Semedo Correia, Baltazar Ricardo Monteiro
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引用次数: 0
Abstract
The Clinical and Health Councils (Conselhos Clínicos e de Saúde - CCS) became responsible for implementing Clinical and Health Governance (Governação Clínica e de Saúde - GCS) in primary health care (PHC) in Portugal. However, this project suffered political abandonment, although there are cases of continuity due to the dedication of CCS professionals. Considering the lack of evidence on the impact of GCS concerning the horizontal integration of the Functional Units of Health Center Groups (Agrupamentos de Centros de Saúde - ACES), the present study sought to identify micropolitical elements that could enhance this horizontal integration. The modified Delphi technique (Policy Delphi) was used as a methodology involving a group of ten experts with experience in academia, in administrative structures, and in the CCS, who shared their experiences to answer the research questions. The results revealed, on the one hand, a general tendency, on the part of the experts to accept that the CCS fulfilled the competences that were assigned. On the other hand, they identified economic and social limitations in the development of the project, as well as the fragmentation of care and tensions generated by disparities between the Functional Units. This study also made it possible to suggest a set of micropolicies capable of promoting the integration of GCS in PHC.
临床和健康理事会(Clínicos e de Saúde - CCS)开始负责在葡萄牙初级卫生保健领域实施临床和健康治理(Clínica e de Saúde - GCS)。然而,该项目遭到了政治上的放弃,尽管由于CCS专业人员的奉献,该项目得以延续。考虑到缺乏证据表明GCS对健康中心集团(Agrupamentos de centrros de Saúde - ACES)功能单位横向整合的影响,本研究试图确定可以增强这种横向整合的微观政治因素。采用改进的德尔菲技术(政策德尔菲)作为一种方法,由10名在学术界、行政结构和CCS方面具有经验的专家组成,他们分享了他们的经验来回答研究问题。结果显示,一方面,专家们普遍倾向于接受CCS完成了被分配的能力。另一方面,他们指出了项目发展中的经济和社会限制,以及各职能单位之间的差异所造成的照顾的分散和紧张。本研究还提出了一套能够促进初级保健中GCS整合的微观政策。
期刊介绍:
Ciência & Saúde Coletiva publishes debates, analyses, and results of research on a Specific Theme considered current and relevant to the field of Collective Health. Its abbreviated title is Ciênc. saúde coletiva, which should be used in bibliographies, footnotes and bibliographical references and strips.