Analysis of pharmaceutical assistance in planning: participation of professionals and qualification of management

Abstract Background The development of Pharmaceutical Assistance, as well as all areas of action of the SUS, is the responsibility of the three managing instances (municipal, state and federal). In this context, the participation of the actors responsible for its management in the forecast planning budget resources for allocation in this area is fundamental, according to their capacity and priority, taking into account the scarcity of resources and the needs verified. Objective To describe the participation of the ones involved in the pharmaceutical assistance, regarding instruments development for budgeting and health planning for their municipalities. Method This paper has analyzed information produced by the project “A assistência farmacêutica nas Redes de Atenção à Saúde: um recorte nas regiões do Projeto QualiSUS-Rede”, where data gathering, conducted from December 2013 to July 2015, in 485 municipalities and the Federal District, was handled through the interview of those in charge of the Pharmaceutical Assistance in the municipalities. The study was cross-sectional and analyzed variables related to the profile of the professionals responsible for Pharmaceutical Assistance regarding professional training, workload and work relationship, as well as the participation of these professionals in the elaboration of the budget planning (PPA, LOA, LDO) and health instruments (PS, PAS, RAG). Complimentarily, we verified the insertion of the planning instruments related to the study period in the SARGSUS System. Results Pharmaceutical assistance (n=417) was low as in the elaboration of the budget planning and health instruments, with a greater participation in the elaboration of PPP (24.0%) and PS (52.0%). Regarding PAS and RAG, there was a greater knowledge of the presence of actions related to pharmaceutical assistance by those who participated in its elaboration (67.0% and 68.8%, respectively). Conclusion The data depict unsatisfactory engagement of the actors responsible for Pharmaceutical Assistance in elaboration and awareness of the actions foreseen at the municipalities’ planning tools and suggests the produced planning instruments may not be linked with the real situation of the health services as well as with the rational use of financing for the Pharmaceutical Assistance.

摘要 背景 药物援助（Pharmaceutical Assistance）以及SUS（巴西统一健康系统）的所有业务领域发展，均由三级管理主体（市政、州级与联邦级）负责。在此背景下，负责该领域管理的主体依据自身能力与优先级，结合资源稀缺性与已核实的实际需求，参与该领域的预算资源分配预测规划工作，是至关重要的。
目的 针对各市政辖区内的预算编制与健康规划工具开发工作，描述参与药物援助工作的相关主体的参与情况。
方法 本研究分析了"A assistência farmacêutica nas Redes de Atenção à Saúde: um recorte nas regiões do Projeto QualiSUS-Rede"（《健康照护网络中的药物援助：QualiSUS-Rede项目区域局部样本》）项目所产生的研究资料。该项目于2013年12月至2015年7月期间，在485个市政辖区及联邦特区开展数据收集工作，通过访谈各市政辖区内负责药物援助工作的人员完成数据采集。本研究为横断面研究，分析了与药物援助负责专业人员相关的多项变量，包括专业培训背景、工作量与工作关系，以及这些专业人员参与预算规划（PPA、LOA、LDO）与健康工具（PS、PAS、RAG）编制的情况。此外，本研究还核实了研究周期内相关规划工具在SARGSUS系统中的录入情况。
结果 参与本次调研的药物援助负责人员（n=417）在预算规划与健康工具编制中的整体参与度偏低，其中在PPP（24.0%）与PS（52.0%）的编制工作中参与度相对更高。针对PAS与RAG而言，参与过相关工具编制的人员对药物援助相关行动的知晓率更高，分别为67.0%与68.8%。
结论 本研究数据显示，各市政辖区内负责药物援助的主体在规划工具编制及对规划中预设行动的知晓度方面，参与度均未达理想水平；这表明所编制的规划工具或未能匹配卫生服务的实际情况，也未能实现药物援助领域融资的合理使用。