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Abstract(s)
O conceito de governação clínica nasceu em resposta a uma crescente burocratização e a um domínio progressivo de «assuntos financeiros» que o National Health Service (NHS), sistema de saúde nacional de saúde britânico, e os seus profissionais de saúde vinham a assistir em finais do século XX, como uma iniciativa para garantir e aumentar os padrões de qualidade dos cuidados de saúde a nível local, por todo o sistema nacional de saúde. A implementação da governação clínica nos Cuidados de Saúde Primários (CSP) portugueses deu-se, principalmente, no contexto de uma reforma iniciada em 2005, que ambicionou desenvolver uma nova cultura de trabalho, com uma gestão mais próxima e com a promoção da governação clínica, de forma a contrariar práticas anacrónicas, excessivamente centralizadoras e burocráticas da administração pública. Esta reforma – consubstanciada pela constituição das Unidades de Saúde Familiar (USF) que têm atingido ótimos resultados em diversos indicadores de qualidade de desempenho, associação de Centros de Saúde em Agrupamentos de Centros de Saúde e criação de outras Unidades Funcionais (UF), introdução de um novo modelo de gestão e instituição da governação clínica, reorganização dos serviços de suporte e informatização completa dos serviços – é considerada uma das mais bem‑sucedidas reformas de serviços públicos das últimas décadas, resultando numa melhoria efetiva do sistema de saúde português. Também o estado de saúde da população portuguesa melhorou consideravelmente ao longo da última década, graças aos CSP e à introdução de melhorias na reforma, revelam diversos estudos. Portugal tem agora CSP que são alvo da atenção internacional pela sua singularidade. Porém, alguns desafios permanecem, sobretudo em relação a uma disparidade verificada em indicadores de qualidade entre o desempenho de umas UF e das novas USF. A esperança reside, então, na vontade existente dos profissionais de saúde, principais atores desta mudança, para que se continue com a evolução.
The concept of clinical governance was born in response to a growing bureaucratization and progressive domination of financial issues that the National Health Service (NHS), the United Kingdom's national health system, and its health professionals came to see in the late century, as an initiative to assure and improve clinical standards at local level, throughout the NHS. The implementation of clinical governance in the Primary Health Care (PHC) of Portugal occurred, mainly, in the context of a reform initiated in 2005, that aimed to develop a new work culture, with closer management and promoting clinical governance, in order to counter anachronistic, excessively centralizing and bureaucratic practices of the public administration. This reform – embodied by the establishment of Family Health Units (FHU) that have achieved excellent results in several performance quality indicators, the association of Health Centers in Health Center Groups and creation of other Functional Units (FU), the introduction of a new management model and institution of clinical governance, the reorganization of support services and a complete computerization of services - is considered to be one of the most successful public service reforms in recent decades, resulting in an effective improvement of the portuguese health system. The health status of the portuguese population has also improved considerably over the past decade, thanks to its PHC and the introduction of improvements in the reform, several studies show. Portugal has now PHC that have drawn international attention for their uniqueness. However, some challenges remain, especially regarding a disparity observed in quality indicators between the performance of some FU and the new FHU. Hope lies, then, in the existing will from health professionals, the main actors of the change, to continue with this evolution.
The concept of clinical governance was born in response to a growing bureaucratization and progressive domination of financial issues that the National Health Service (NHS), the United Kingdom's national health system, and its health professionals came to see in the late century, as an initiative to assure and improve clinical standards at local level, throughout the NHS. The implementation of clinical governance in the Primary Health Care (PHC) of Portugal occurred, mainly, in the context of a reform initiated in 2005, that aimed to develop a new work culture, with closer management and promoting clinical governance, in order to counter anachronistic, excessively centralizing and bureaucratic practices of the public administration. This reform – embodied by the establishment of Family Health Units (FHU) that have achieved excellent results in several performance quality indicators, the association of Health Centers in Health Center Groups and creation of other Functional Units (FU), the introduction of a new management model and institution of clinical governance, the reorganization of support services and a complete computerization of services - is considered to be one of the most successful public service reforms in recent decades, resulting in an effective improvement of the portuguese health system. The health status of the portuguese population has also improved considerably over the past decade, thanks to its PHC and the introduction of improvements in the reform, several studies show. Portugal has now PHC that have drawn international attention for their uniqueness. However, some challenges remain, especially regarding a disparity observed in quality indicators between the performance of some FU and the new FHU. Hope lies, then, in the existing will from health professionals, the main actors of the change, to continue with this evolution.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Keywords
Governação clínica Cuidados de saúde primários Unidade de saúde familiar Centro de saúde Portugal