Coordenação das ações e serviços de saúde na assistência prestada às pessoas que vivem com HIV/AIDS em município do Noroeste Paulista

Abstract

This study aimed to analyze the coordination of health actions and services in the care provided to people living with HIV/Aids taking as an axis of analysis the integration of actions and services within the reference teams and with other professionals/specialties/services. Method: This is an exploratory, survey-type study, with a quantitative approach in which 320 people living with HIV/Aids participated. Interviews were conducted, using a specific instrument, containing questions about sociodemographic data, clinical characteristics, health services used and coordination of assistance with other professionals / specialties / services. For data analysis, descriptive statistical techniques were used and coordination indicators were constructed, which were classified as: unsatisfactory (values between 1 and 2.5 corresponding to values up to 50% of the scale), regular (greater than 2.5 and less than 3.5, corresponding to values between 50% and 70% of the scale) and satisfactory (greater than 3.5, corresponding to values greater than 70% of the scale). Results: Most of the interviewees, 63.1%, were male, 93.3% were asymptomatic, 90.6% had an undetectable viral load and 71.6% had been on antiretroviral treatment for less than 10 years, being a minimum of 1 and a maximum of 33 years. The highlight was 94.4% who used public services exclusively, focusing on primary health care and emergency care. The coordination of care provided to people living with HIV/Aids with other professionals / specialties / services was considered regular with averages of 2.90 and 3.46, respectively. Individual indicators classified as satisfactory: health professionals read the medical record during the consultation; annotation in medical records during the consultation; test results are available on the day of the consultation; questioning about the regularity of medication intake; questioning about side effects; assistance in scheduling appointments in other services; proof of appointment at another service; and providing assistance when forwarded. They obtained a regular classification: questioning about complications related to the disease; discussion of service locations when referred; receiving written information to deliver to the other service; returns from the other service with written information and interest of health professionals regarding the care provided in another service. The indicators: delivery of printed exam results; notification of scheduling appointments and returns; questioning about living conditions, receiving support, contact with NGOs, neighborhood associations or others to contribute to the treatment and discussion with other professionals / services / NGOs, about care provided in another service, obtained unsatisfactory results. Conclusion: The coordination of assistance to people living with HIV / AIDS was assessed as regular. The weaknesses found were related to the fragmented focus of assistance and failures in communication between services with regard to the provision of printed materials, reference and counter reference guides, reinforcing the need to establish an interdisciplinary work on the use of data contained in information systems in order to ensure continuity and integrality of care.