Linhas de cuidado de atenção integral à saúde, dispositivo de gestão no sistema único de saúde: revisão narrativa

Abstract

Introduction. The Federal Constitution of 1988 assigns articles 196 to 200 for the description of the Unified Health System (SUS), which contains as principles the universality of access; comprehensive care and health equity. It emphasizes that the organization and functioning of health services must occur in a decentralized, regionalized way, hierarchized by increasing levels of complexity. The SUS structuring legislation incorporates the principle of community participation as a right and duty of citizens and encompasses the concept of territoriality to facilitate health planning and access of population demands to different services and levels of complexity in the system (BRASIL, 1988; 2003). Studies indicate that the proposed organization of health care and health systems in health care networks, coordinated by the PHC, can significantly impact the health of the community, with affordable costs based on the legal and political framework of the SUS. The lines of care are presented as strategic management devices to overcome the disarticulation between the different levels of health care, bringing primary, secondary and tertiary care closer together. In this approach, the continuity of comprehensive care is sought, which includes actions from health promotion to treatment and rehabilitation, with an agile and timely flow at each level of care (BRASIL, 2004; RODRIGUES et al., 2014). Goal. Contextualize the lines of comprehensive care in health care, as a strategy capable of providing better health management, in light of publications on the subject. Methodology. Narrative study of literature, focusing on the description and discussion of the development or the "state of the art" of a given subject, from a theoretical or contextual point of view. Narrative reviews make it possible to analyze the literature published in books, printed and/or electronic journal articles in interpretation from the point of view of the author's personal critical analysis. The purpose of the narrative review is to demonstrate knowledge about a broad issue through literature review (ROTHER, 2007; MARTINS, 2018). To select the material, searches were carried out for articles in the databases Latin American and Caribbean Literature on Health Sciences (LILACS), Virtual Health Library/Nursing Database (BVS/BDENF), and in the VHL/ Ministry of Health, using descriptors in Health Sciences (DeCS): nursing, primary care, line of care articulated by Boolean operators AND. Results and Discussion. The search found a grand total of 47 articles, with 41 articles being excluded, 12 for being inconsistent with the intended objectives and 27 for being outside the research focus. The critical, detailed and reflective reading made it possible to include a total of 06 articles that met the established inclusion criteria. There was an emphasis on the Line of Care from the perspective of achieving comprehensiveness in different areas of knowledge and/or life cycle. The study by Araújo et al (2019) demonstrated in its results the importance of the Systematization of Nursing Care, as a tool that enhances health care. Given the findings and reflections, support was found in the understanding that the Health Care Network is organized by different lines of care and/or themes, where the user can be linked to more than one line simultaneously, with the expression of the subjectivity of the individual and comprehensive care (JÚNIOR, 2021; PEREIRA; LIMA, 2008). As for the context of CL implementation, it was observed that the included studies corroborated the aspects that are relevant in the construction and preparation of the CL, with emphasis on the structure of services, the work process, the dimensioning of health teams, the concept of Health Care Network, Primary Health Care, comprehensive and comprehensive care, multidisciplinary team, SAE and professional nurse. The quality of the service provided and the problem-solving capacity were emphasized as results that can be achieved through the implementation of flows that are ordered and coordinated by the PHC, which can enhance access to health services, with greater efficiency and cost optimization. Final considerations. The study allowed us to observe that the strategy of construction of Lines of Comprehensive Health Care is a fundamental movement in the structure of the health system organization, in order to qualify work processes and ensure greater and better resolution of the population's health problems.