Custos e efetividade na atenção básica à saúde: reestruturação do serviço de medicina integral no Hospital Naval de Recife

Abstract

The 1970s was an important milestone in the discussions that laid the theoretical foundations for Primary Health Care. On the other hand, the following decade brought concerns about the change in the demographic and epidemiological profile of the population around the world, combined with restrictive economic contexts and the increase in health expenditure resulting from the disorderly incorporation of high-cost technologies, a fact that drove the adoption of these strategies, which have been applied in several countries. Despite the longer time taken by Brazilian society to aggregate efforts in the same direction, it can be said that the results of Primary Health Care are one of the greatest benefits that the Unified Health System has brought to the nation. In the same way, the Brazilian Navy conceived the Integral Medicine Service, which was implemented at the Naval Hospital in Recife, but the desired results were not observed. This paper presents, based on a theoretical framework, an intervention project that aimed to improve the current structure of the Comprehensive Medicine Service at the Recife Naval Hospital, giving it greater effectiveness, focusing especially on defining protocols, training, technical guidance for the professionals involved, expanding access and implementing an appropriate methodology for evaluating the service.