Avaliação do processo de trabalho em Centros Especializados de Reabilitação do Brasil

Abstract

Introduction: The Care Network for People with Disabilities (RCPCD) aims to expand access, qualify health care, promote the linking of people with disabilities and their families to health care points and ensure the articulation and integration of these points in the national territories. In this Network, Specialized Care is composed of services in a single modality or with at least two modalities, called Specialized Rehabilitation Centers (CER). The work process in the CERs must contain assistance actions, organization of flows and practices of continuous health care of the user and also coordinate and articulate the different points of attention of the network in each territory. The evaluation of the work process of professionals included in the RCPCD by the CER is an alternative to know how they organize themselves in the production of care and organization of the network, as the actions developed directly compromise patient safety and the quality of care. Objective: The study aimed to describe the work process at the CER and its association with individual characteristics of workers and the context of the health macro-regions where the services are located. Methodology: This is a multicenter, cross-sectional study carried out in

CERs in the five Brazilian geographic regions. For analysis of the work process, part of a self- administered questionnaire was used and directed to CER professionals. Data collection took

place in the workplace and, due to the Covid-19 Pandemic, in the most distant municipalities, the collection was carried out online. Descriptive analysis was performed by absolute and relative frequencies and means and standard deviation and bivariate inferential analysis followed by Asymmetric Linear Regression Model. Results: The sample consisted of 1826 CER workers from 8 Brazilian states. The workers' mean age was 37.52 (±9.59) years, 84.5% were female and 27.6% were physical therapists. The predominant work regime was a contract with employment registration in accordance with the Consolidation of Labor Laws (CLT). Regarding satisfaction, 88.6% reported good job satisfaction. A large part of the sample has never performed or does not know what a Singular Therapeutic Project and Matrix Support is. It is also not a routine practice to establish flows and practices of health care for users articulated between health services in the network and teaching. The context variable coverage of Primary Care showed a non-linear relationship with the work process, whereas the HDI showed no association.