A Política Nacional de Saúde da Pessoa Idosa (PNSPI) e a atenção básica : um estudo de caso no município de Santa Cruz do Sul/RS.

Abstract

Health is a right of the Brazilian citizen and a duty of the State, this right being expressed in the Federal Constitution of 1988. In Brazil, we observe the growing of the ageing population. In this context, it is necessary to invest in health care for the elderly, since many seniors will use the Unified Health System (SUS) as the primary means of access to healthcare. This study analyzed the National Health Policy for the Elderly (PNSPI) in Santa Cruz do Sul and 13th Health Regional Coordination (CRS), in particular the organization of primary care in relation to the elderly, and access to health care of the elderly services and actions of the municipal primary care. The work was guided by the following objectives: to analyze the implementation, of PNSPI in Santa Cruz do Sul and 13th CRS; identify the forms of organization of the primary health care in regard to the health of the elderly; and check the access and use of health actions and services by the elderly to primary health care in Santa Cruz do Sul. This work is characterized by a qualitative research of exploratory-descriptive means. For the construction of knowledge was used theoretical and methodological fundamentals of Dialectical Materialism History. Were organized and analyzed secondary data, interviews with four managers, ten professionals from primary health care and twenty SUS users elderly were conducted. This study aimed to build knowledge in order to assist in the development of the city and area surveyed, contributing to the expansion and quality of health care for the elderly. As for the research results, first, are presented secondary data on the elderly population, gender and household situation, life expectancy, the Human Development Index (HDI) and health services, respectively, in Brazil, Rio Grande South, 13th CRS and Santa Cruz do Sul. These data demonstrate the increasing elderly population, the feminization of old age and the migration of older people to urban areas, with indexes that indicate increased longevity and present the services present in the territorial scales studied. The primary data were analyzed and presented from the perspective of different actors in the primary health care system: managers, professionals and users. Thus, it appears that: there is no PNSPI implemented in the city studied; there is a low participation of older people in the management of public health policies; there is a weakness in the relationship between managers and sectors; the health of the elderly has little visibility on the public agenda; there is an inconsistency between the institutional responsibilities and the performance of the managers; access to and use of health services by the elderly users is still precarious; the health care enhances territorial; there is a weakening of the shares in aging health; there is the precariousness of primary care; There is a strong link between professionals and elderly users of health services; there are deficiencies in shared care with other services; the elderly have a positive outlook on access and use of the shares of primary care, while there are difficulties in access to and use of services.The PNSPI and other public policies ensure the elderly population the right to health, however, there is a distance between the provisions of Brazilian law and the reality of the elderly population within the primary health care system.