The Regionalization Process in Brazil: influence on Policy, Structure and Organization dimensions

<div><p>Abstract Objectives: to analyze the influence and performance on Policy, Structure and Organization dimensions in the regionalization process in five health regions in Brazil. Methods: a quantitative, cross-sectional study using primary data from 217 fulfilled interviews with managers, service providers and representatives of society in five health regions in Brazil. Calculation on the Influence Index that measures the contribution level of three dimensions in regionalization. Results: after analyzing the three dimensions that influence the regionalization process separately, it is necessary to point out that there is a better performance on the Policy dimension in front of all the others; on the other hand, Structure dimension shows itself to be feeble, configuring a real obstacle to progress the regionalization process; Organization occupies an intermediate place in all the regions of the study. The insufficient availability of physical, human and financial resources impedes to advance the regionalization and the achievement of its major objectives, which are the integration of services and coordination care. Conclusions: regionalization follows an uncertain path and without clear direction of its objectives, goals and deployed instruments. The Regional planning, in the case of health, is still a theoretical exercise.</p></div

Region and Networks: multidimensional and multilevel approaches to analyze the health regionalization process in Brazil

<div><p>Abstract Objectives: to present a methodology used by the Policy, Planning and Region Management research and the Health Care Networks in Brazil - the Regions and Networks research. Methods: description of the analytical scheme in the process of choosing health regions and criteria to select cities and health units, instruments for collecting primary and secondary data and the indicators database, besides the regional typology elaborated for data analysis. Results: the analytical scheme is based on the health policy analysis; policy, structure and organization were defined as the macro dimensions. For each one of these, sub-dimensions were defined. The questionnaire was elaborated by variables that were possible to analyze the regionalization process determinants. Five health regions were selected from the previously defined criteria. Conclusions: the method allowed to establish attributes in the regionalization, constructed by specific components - integration, coordination and regulation. The multilevel approach was important because it portrayed different perceptions from the stakeholder managers and providers according to their bonds in the city, regional and state scenarios.</p></div