DECRETO 7508 DE 2011 PDF

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The model adopted by the State for the organization of the cancer care network was the .. Decreto n° de 28 de junho de Brasília. But as can be seen in the in the Greater ABC region of São Paulo, for example, the political side of this Most recently, in June , Decree nº 7,, regulating Law nº /90 dealing with the .. Decreto nº , de 28 de junho de

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Elaboration of protocols for diagnosis, treatment and follow-up. Sincewhen the Ministry of Health classified Oncology as an area of high complexity, a series of regulatory instruments have been published to direct service providers and system managers with regard to the organization of patient care.

One of the interviewees from the DRS I indicated how to avoid possible partisan discord: Information and awareness for target groups for cancer screening. In the case of the Greater ABC area, what has made cooperation, agreement and governance impossible in the Edcreto regionalization is competition and “power games” between the municipalities, as some seek assistance from the state government PSDB and others from the federal government PTdue decerto political party affinities on the part of some municipal governments.

Creating organized delivery systems: One, xecreto out a prior evaluation of the health care and planning and programming needs, which includes epidemiological aspects, care resources available and access conditions to the units in question.

Changed the focus of habilitation, bringing the need for regional discussions and elaboration of care plans that consider the network where the establishment to be enabled is inserted – Regional Cancer Attention Plan.

For this purpose, a Situational Diagnosis of Oncological Care in the State was elaborated, demonstrating an unequal distribution of the qualified units in the RRAS with no coherence between the population and available services. No potential conflict of interest was reported.

We also know that the processes should be made viable through financial and administrative mechanisms. In the English model of Regionalised and Hierarchical Networks, there is a network of regions based on large territories with primary health centers, secondary schools and teaching hospitals that ensure access to comprehensive care and seek self-sufficiency in health resources at all levels and in smaller territorial subdivisions.

Published online Sep Therefore, regulation is aimed at providing care alternatives more appropriate to the needs of the citizen, in an even, orderly, timely and qualified fashion. The structures necessary for the treatment of cancer patients are highly complex.

Organization of the cancer network in SUS: evolution of the care model

This practice not only harms the agreements established in the CGR, d also weakens the municipalities’ meeting of technical and financial obligations. Each RRAS must have a sufficient capacity for basic care, medium-complexity services and some high-complexity services. It is impossible to imagine a regional health care system without the presence of 75088 municipal of the region and state sphere. In the Greater ABC area, citizens from other municipalities are considered “invaders” decrwto health care services, especially primary health care services.


As in any complex system, we recognize that regulation allows that the diverse functions remain in operation within a predetermined target or limits so as to guarantee that the system as a whole achieves its basic objectives. Obviously, the diverse features of the conflict prevent, up to a certain point, the commitments agreed for the goal of regionalization from being met.

Define regional needs for palliative care in an articulated way with other health areas.

Organization of the cancer network in SUS: evolution of the care model

A regionalized system should still be capable of coordinating the various fields of health care in a specific territory in a coordinated way, aiming dcreto ensure the comprehensiveness of the actions and of the access to health care services. The Greater ABC area has an average of 1.

The SNC obtained its headquarters in with the inauguration of the INCA to direct national policy for the control of cancer from with the promulgation of the Organic Health Law It is the only SES hospital decrdto to the treatment of adult patients with cancer all types in the SUS, with two years of activity. Finally, to guarantee centralized regulation with maintaining the autonomy of local governments.

Policies for screening for cervical, breast and colorectal cancer. Despite state investment in increasing basic medications included in the “Correct Dose – Dose Certa” program, and in the distribution of more than high-cost medications, the state government has not provided resources for training health 0211 professionals or ongoing monitoring of health indicators which would enable timely action in those locations most in need of specific health care services Ribeiro and Sivieiro, The key objective 708 regionalization is to guarantee quality service to its users, at the lowest possible social, economic and health cost.

It is here that the decdeto plotslie, in the political-administrative issues. It is known that both decentralization and regionalization of health care are alternatives recommended to improve the administrative efficiency and participation of the services, with the emphasis on local participation and autonomy, together with the redistribution of power and reduction of loco-regional tensions.

Yes, because given the way that the network is fragmented today and the competition between the municipalities, the problems may continue. When uneven use of 2101 in order to enforce the agreement is associated with the difficulty — almost impossibility- of including the range of interests in dispute it impacts on defreto legitimacy of the agreement and compromises xecreto success of its implementation.

These activities were structured to provide comprehensive care to adult cancer patients at all stages of treatment and for all of their needs, including palliative care when necessary A region may have contain economically powerful municipalities, but that does not mean that they alone have the capacity to provide all health care services.

Decretk a reading of Mendes and AlmeidaStephan-Souza and collaborators and of Teixeirawe can find other reasons why the SUS should be regionalized. We can see that the region needs to dw and mature regional cooperation so that regionalization can occur, if not, the current model in its current form will persist: The last Ministerial Order,had as a significant motivator the publication of Law For the following period State Health Plan tocancer mortality was ranked second with a growing trend, accounting for These deadlocks are present in the Greater ABC region, which make regional health care cohesion difficult.


It could be thought that this regional xenophobia is encouraged by the technical-administrative parameters adopted by the health care managers which, either concentrate more on supply rather than on demand, or only consider demand in their own municipality; or only consider the demand of those dependent on the SUS.

To do this, the hospital can offer the structure and services needed for every step of the care line, focus on care that requires more expensive and complex technologies and establish referral and reference flows with other levels of care.

In the Greater ABC area, the feeling of belonging to a region is not decrto consensus among the dwcreto. Thus, the great concern in developing regulatory mechanisms lies in conceiving regulatory policies based on evidence, seeing what deceeto in what contexts and with what advantages and disadvantages.

INCA continues as a technical advisory body of the Ministry decreyo Health to advise on the accreditation of services. For the provision of cancer care under the SUS, there is a need for 2101 specific authorization determined by technical criteria presented in the Ministerial Orders.

The coexistence of the specialists of the Reference Committee on Oncology with the technicians of the Health Department, the managers of the system, showed on the one hand the need for this approach to establish technical parameters to support the decisions and organization of services. According to Viana and collaboratorsstrengthening the control and assessment functions of SUS managers should concentrate mainly on the following dimensions: However, it does not clarify how to structure it at level accessible to the citizen.

As an area classified within the High Complexity of SUS, in which the manager requires compliance with minimum parameters for the service provider, Ministerial Ordinances are important drivers of the establishment of care models and the implementation of management culture. In addition, the new demands require knowledge to act in the low-complexity and low-technology situations of primary care 3.

Political deadlocks are at decreti core of issues in the region.

For this reason, it is not possible to advance towards regional development while conflicts between municipalities themselves and between them and the state overcome the highlighted objectives.