Redes de atenção à saúde: a importância da referência e contrarreferência para a atuação integral na medicina

Abstract

Healthcare Networks are organized to pursue comprehensive care for populations in various territories. Therefore, the reference and counter-reference system is employed as a strategy to ensure the basic principles of the Brazilian Unified Health System (SUS). Reference is the process of referring a patient to a higher level of complexity, such as specialized services and hospital care, while counter-reference involves the patient’s return to primary care (Basic Health Units). This study is characterized as exploratory, descriptive, and qualitative, whose objectives are: to diagnose the reference and counter-reference processes in Healthcare Networks (RAS) in Medicine; to understand the sociodemographic and professional profile of physicians in Primary Health Care and hospital contexts; to describe the reference and counter-reference processes carried out by these professionals; and to discuss the impacts that the presence or absence of these processes may cause. The participants included 12 medical professionals (6 from medium and high complexity levels and 6 from Primary Health Care), who underwent semi-structured interviews and completed a sociodemographic and professional questionnaire. The interviews were thematically analyzed and interpreted collectively. Four categories emerged from the thematic content analysis. Nevertheless, through this analysis, the importance of healthcare networks in the context of public health can be measured, and the significance of reference and counter-reference processes for healthcare delivery, as well as the drawbacks resulting from their absence. Additionally, possible improvements in implementing these processes can be identified.