A POLÍTICA SOCIAL DE TRATAMENTO FORA DE DOMICÍLIO (TFD) E A GARANTIA DE DIREITOS NOS CUIDADOS EM SAÚDE NA ASSISTÊNCIA À POPULAÇÃO POBRE

Abstract

This investigative study aimed to analyze, from the perspective of law, how the conditions of access and guarantees of users attending the Lauro Wanderley University Hospital (HULW) are regarding the benefits of Out-of-Domicile Treatment (TFD) as a social policy implemented in the municipalities of origin of these users. In this sense, this study sought to understand whether the right to TFD is fully guaranteed to SUS users and how it has been implemented in Paraíba, with reference to the research carried out with users who undergo treatment at the HULW Outpatient Clinic residing in other municipalities of Paraíba. This was a field research with a predominantly qualitative approach and quantitative information, subsidized by bibliographic and documental research to substantiate the proposal. As for the data collection instruments, a structured interview form was used, which was carried out with the users and, complementarily, with the companions. To analyze the data obtained, we used the content analysis technique of the interviewees' answers, aiming to understand them critically, based on the dialectical perspective of social processes. Due to the amplitude of the universe, the care at the HULW outpatient clinic, the sample chosen was by accessibility during the period chosen by the researcher to finish the end-of-course work. Therefore, the quantitative defined was by saturation of users/attendants approached, reaching the quantitative of 20 interviews carried out during the period of four weeks, available to the researcher. The investigative proposal has the perspective of presenting information about the assisted user, subsidizing the performance of social workers at HULW by systematizing socioeconomic, political and cultural data necessary to identify the social determinants that interfere in the health care of users in social policy institutions, providing better quality of care to the demands. The results will also be able to collaborate with the knowledge of municipal managers regarding the guarantee of rights. The analysis and discussion of the research data indicate traces of the study hypothesis, which assumed that the SAS/MS Administrative Rule no. 55/1999 delegates to the municipality compliance with the TFD, based on the State Manual; however, users do not have full access, or have precarious access to the benefits, due to the lack of strategic, political and economic planning, availability of resources and investments in the perspective of law by municipal managers. The ways in which the municipalities organize the TFD are different, but management disorganization and lack of commitment to extended rights prevail. In the fragments of the speeches, the complaints about adequate transportation, long travel hours, lack of meal and overnight allowances reflect how Paraíba's municipal managers organize the TFD, offering it in a disorganized, circumstantial, lacking continuity, partial, neglected way, in short, taking on welfare characteristics and not making effective the character of an imminent right. Given the perception of users, it is possible to identify that even the services as they are offered are still compromised in terms of the quality of access to the TFD.