Avaliação dos encaminhamentos da Atenção Primária a Saúde para Atenção Ambulatorial Especializada em Nutrição em uma Área Programática do Município do Rio de Janeiro

Abstract

Primary Health Care (PHC) is the preferred gateway to the Health Care Network (RAS), acting as a care coordinator, enabling users to access other levels of care. In the Unified Health System (SUS), assistance control allows the provision of health services that are more equal and adequate to the needs of users. Among the procedures regulated in SUS, highlighted as food and nutrition that have an important impact on the health of people, families and communities. This work aims to evaluate the PHC referrals for Specialized Outpatient Care (SEA) in nutrition, in AP 3.1 of the Municipality of Rio de Janeiro. This is a cross-sectional study of referrals that use as databases of the National Regulation System (SISREG) of the municipality of Rio de Janeiro, having as objects of study requests for "consultation in nutrition", "consultation in nutrition and pediatrics", Consultation in Nutrology "and" Consultation in Child Nutrology ". The data collected refer to the period from January 1, 2018 to July 31, 2018. Only data related to Basic Health Units (UBS) Requesting AP 3.1 were analyzed. A total of 1352 referrals were found from January 1, 2018 to July 31, 2018, with 699 referrals having their justifications evaluated, related to the period from May to July 2018. Most referrals refer to patients from females, adults and had risk classification for blue referral. Regarding the informed ICD, about 44% of the patients were obese, 19% were diabetic and 7% were hypertensive, and the majority had associated comorbidities. No justification changes contained in the applicable referrals, most referrals (87.7%) have some justification in their description, and 39.8% of the referrals contained at least two criteria suggested as an adequate justification. Regarding the influence of RAS support supports, such as the Family Health Support Center (NASF), 72.8% of the referrals requested were recovered from basic units that did not have NASF support. In referrals that supported NASF, 62.0% were related to basic units requested that did not have the professional nutritionist from the NASF team. The resolution of care depends on the interaction of different points of care in the network, such as Primary Care and Secondary Care, so that regulatory practice can promote the integrity and integrity of care. The potential of the NASF team's support to PHC and the importance of the nutritional professional insertion in the contribution of the population's health care process was verified, observing the highest percentage of referrals where there was no NASF support.