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Publication
Articulação entre os níveis de gestão da rede nacional de cuidados continuados integrados na região do Alentejo: um diagnóstico para a melhoria dos processos de gestão
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Abstract(s)
À medida que as multimorbilidades aumentam nas sociedades envelhecidas, a gestão dos Cuidados Continuados Integrados torna-se um desafio para os sistemas de saúde. Diferentes países têm desenvolvido abordagens e modelos de gestão para enfrentar essa complexidade. Em Portugal, a Rede Nacional de Cuidados Continuados Integrados (RNCCI) surge como uma resposta que visa fornecer cuidados de saúde e apoio social, visando a autonomia e qualidade de vida das pessoas em situação de dependência. Esta Rede tem por base um modelo de gestão que se baseia numa lógica de descentralização e contratualização de serviços, desenvolvendo-se a vários níveis de intervenção e competências, com coresponsabilidade e articulação a nível inter e intrasetorial, interinstitucional e interprofissional. A presente investigação tem como finalidade diagnosticar a situação da RNCCI na região de Saúde do Alentejo, com o objetivo de analisar a articulação entre os níveis institucionais da Rede, identificar áreas críticas e recomendar ações de gestão. O estudo segue uma metodologia mista, com uma abordagem exploratória e sequencial. Recorre a duas fontes de dados: 1) indicadores relativos à atividade assistencial, entre 2017-2023, provenientes de diferentes sistemas de informação; 2) entrevistas e questionários aplicados às equipas da RNCCI. Aplicaram-se dois métodos de análise de dados: o COSTATIS, enquanto método de Análise de Dados de Três-Vias; e a análise Importância-Desempenho, enquanto ferramenta diagnóstica de gestão. Os resultados do estudo fornecem insights teóricos e práticos, destacando lacunas e pontos fortes nos processos de gestão da RNCCI. Conclui-se que existem áreas prioritárias que carecem de estratégias mais eficazes e ajustadas às diferentes realidades e especificidades das sub-regiões e equipes. A articulação entre diferentes níveis institucionais e equipes é essencial para melhorar a eficiência e a qualidade dos cuidados prestados. A investigação oferece uma base para desenvolver estratégias futuras que melhorem os processos chave da RNCCI na região do Alentejo.
As multimorbidities increase in ageing societies, the management of Long-term Care becomes a challenge for healthcare systems. Different countries have developed approaches and management models to address this complexity. In Portugal, the National Network of Integrated Continuous Care (RNCCI) emerges as a response aimed at providing healthcare and social support, promoting autonomy and quality of life for people in situations of dependency. This network is based on a management model grounded in decentralisation and service contracting, developing at various levels of intervention and competence, with co-responsibility and articulation at inter and intra sectoral, inter-institutional, and inter-professional levels. This investigation aims to diagnose the state of the RNCCI in the Alentejo Health Region, with the objective of analysing the articulation between the institutional levels of the network, identifying critical areas, and recommending management actions. The study follows a mixed methodology with an exploratory and sequential approach. It relies on two data sources: 1) indicators related to care activity between 2017-2023 from different Information Systems; 2) interviews and questionnaires applied to RNCCI teams and units. Two data analysis methods were applied: COSTATIS, as a Three-Way Data Analysis method, and Importance-Performance Analysis, as a management diagnostic tool. The study's results provide theoretical and practical insights, highlighting gaps and strengths in RNCCI management processes. It is concluded that there are priority areas requiring more effective strategies tailored to the different realities and specificities of the sub-regions and teams. The articulation between different institutional levels and teams is essential to improve the efficiency and quality of care provided. The research provides a foundation for developing future strategies to enhance key processes of the RNCCI in the Alentejo region
As multimorbidities increase in ageing societies, the management of Long-term Care becomes a challenge for healthcare systems. Different countries have developed approaches and management models to address this complexity. In Portugal, the National Network of Integrated Continuous Care (RNCCI) emerges as a response aimed at providing healthcare and social support, promoting autonomy and quality of life for people in situations of dependency. This network is based on a management model grounded in decentralisation and service contracting, developing at various levels of intervention and competence, with co-responsibility and articulation at inter and intra sectoral, inter-institutional, and inter-professional levels. This investigation aims to diagnose the state of the RNCCI in the Alentejo Health Region, with the objective of analysing the articulation between the institutional levels of the network, identifying critical areas, and recommending management actions. The study follows a mixed methodology with an exploratory and sequential approach. It relies on two data sources: 1) indicators related to care activity between 2017-2023 from different Information Systems; 2) interviews and questionnaires applied to RNCCI teams and units. Two data analysis methods were applied: COSTATIS, as a Three-Way Data Analysis method, and Importance-Performance Analysis, as a management diagnostic tool. The study's results provide theoretical and practical insights, highlighting gaps and strengths in RNCCI management processes. It is concluded that there are priority areas requiring more effective strategies tailored to the different realities and specificities of the sub-regions and teams. The articulation between different institutional levels and teams is essential to improve the efficiency and quality of care provided. The research provides a foundation for developing future strategies to enhance key processes of the RNCCI in the Alentejo region
Description
Keywords
Análise Importância-Desempenho COSTATIS Cuidados Continuados Integrados Gestão em Saúde Multimorbilidades RNCCI