OSCIP e SUS: ligações possíveis a partir de um estudo de caso

Abstract

In Brazil, private public interest initiatives undertaken in the third sector have assumed an important role in civil society by complementing the health care provided by the public health network. In São Carlos, a city located in São Paulo state, the Multidisciplinary Health Care Center (CAMS) association represents a specific model of care that is defined as a Public Interest Civil Society Organization (OSCIP), which enables the provision of health care to low income population. Since CAMS handles a great number of cases concerning mental health care and physical and psychosocial rehabilitation of patients that have a socioeconomic status similar to that of Unified Health System (SUS) users, a study addressing this specific OSCIP was necessary to evaluate the aspects regarding patient referral to CAMS and which health care needs are met. This is a cross-sectional case study that aimed to investigate the health care demand using empirical data. The proposed methodological approach used enabled the analysis of the existing articulation between local SUS and CAMS; to describe and characterize the profile of the users and the demands that arrived at the CAMS and to identify the flows established between the municipal health services and CAMS. Therefore, a research was carried out in CAMS’ patient socioeconomic status screening database for one year. Data were entered into spreadsheets to determine the main socioeconomic characteristics of the studied population, the services sought, and the source of the referrals. Results showed that the majority of patients were women under 30 years old who had completed primary education, who did not have a private health care plan, and whose income was lower than minimum wage. These findings show that these are characteristics similar to those of SUS’ patients. The most commonly sought services highlighted the weaknesses of Sao Carlos’ Health Care Network (RAS): mental health and child health. The main source of referrals public services which were not necessarily included in the RAS: equipment and services of a public university, which configured a specific relationship between CAMS and university. In an effort to meet a specific demand for specialized health care, CAMS’ operations bring to light the deficiencies and shortcomings of the public health care system in Sao Carlos. It is concluded that the results can support future planning and communication actions between CAMS, the public university and the local SUS, aiming to minimize fragility of care in Mental Health and Child Health.