Fifteen years of the Primary Health Care Reform (RCAPS) in Rio de Janeiro, Brazil.

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ciencia & saude coletiva Pub Date : 2025-07-01 Epub Date: 2025-03-23 DOI:10.1590/1413-81232025307.04112025
Luiz Felipe Pinto, Ana Luiza Ferreira Rodrigues Caldas
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引用次数: 0

Abstract

Rio de Janeiro has become a paradigm for Brazilian Primary Health Care (PHC). How did the city, which until 2008 was the capital city of the country with the lowest coverage of complete Family Health Strategy (FHS) teams, with 3.5% of its population, manage to give access to more than 70% of cariocas (residents of the city of Rio de Janeiro) by 2024? The present study analyzes the main axes and results of the Primary Health Care Reform (Reforma dos Cuidados em Atenção Primária à Saúde - RCAPS) over a 15-year period, inspired by PHC in Lisbon, Portugal. Limits, challenges, and advances are discussed. Our study highlights changes in the organizational chart, the management model, health care by results, and the strengthening of PHC as a network organizer and care coordinator. The feasibility of RCAPS for a large city is demonstrated, with the following limitations: (i) the need to reorganize continuing education processes, (ii) improved communication with the SUS user population, and (iii) insufficient tripartite funding, especially from the state government. Digital Health as an axis for improving communication, expanding access, and greater resolutiveness is today consolidated as management's greatest challenge.

巴西里约热内卢15年初级卫生保健改革(RCAPS)
里约热内卢已成为巴西初级卫生保健(PHC)的典范。在2008年之前,里约热内卢一直是家庭健康战略(FHS)团队覆盖率最低的国家的首都,人口仅占其总人口的3.5%,但到2024年,它是如何让70%以上的cariocas(里约热内卢市的居民)获得医疗服务的?本研究受葡萄牙里斯本初级卫生保健中心的启发,分析了15年来初级卫生保健改革(Reforma dos Cuidados em aten o Primária Saúde - RCAPS)的主轴和结果。讨论了限制、挑战和进步。我们的研究强调了组织结构图、管理模式、结果保健以及初级保健作为网络组织者和保健协调员的加强方面的变化。本文论证了在大城市实施RCAPS的可行性,但存在以下局限性:(i)需要重组继续教育流程;(ii)改善与SUS用户群体的沟通;(iii)三方资金不足,尤其是州政府的资金不足。数字健康作为改善沟通、扩大可及性和提高决心的轴心,如今已被巩固为管理层面临的最大挑战。
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来源期刊
Ciencia & saude coletiva
Ciencia & saude coletiva PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.60
自引率
11.80%
发文量
533
审稿时长
12 weeks
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.
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