Specialized care and health transport from a Health Care Network integration perspective

The aim of this study was to analyze the organization and provision of specialized care (SC) and health transport in regional polyclinics in the state of Bahia, Brazil. We conducted a qual-itative exploratory single case study of a polyclinic based on semi-structured interviews with key in-formants in municipal and state health services. We sought to identify elements that characterize network-based models of SC. A number of ad-vances were identified, including: an increase in the provision of SC and the scope and quality of services; effective retention of health professionals; provision of health transport; monitoring of SC; and improvements in the regulation of access to care through the use of computerized systems. The following challenges were observed: tailoring SC planning to regional health needs; the promotion of care coordination by Primary Health Care (PHC); the development of strategies to improve commu-nication between SC and PHC professionals; in-stitutionalization of counter-referral; engagement between the polyclinic and spaces for citizen par-ticipation; and fostering matrix support, perma-nent education, teaching-service integration, and research. Despite the intrinsic challenges of SC and the need to strengthen the central role of PHC, the regional polyclinic arrangement is better suited to the integration of the health care networks.