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Mobile Emergency Care Service: analysis of Brazilian policy
Cristiani Vieira Machado1, Fernanda Gonçalves Ferreira Salvador, Gisele O'Dwyer
1Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil. cristiani@ensp.fiocruz.br
Objective:
To analyze the configuration of mobile emergency health care policy in Brazil.
Methodological Procedures:
The study was based on public policy analysis. Bibliographic and document review, analysis of official data and interviews with federal administrators related to formulation and implementation of the Mobile Emergency Care Service (SAMU) in Brazil in the 2000s were performed.
Analysis Of Results:
Priority was given to SAMU at the federal level since 2003. During the first years of implementation, municipal level services predominated; in 2008, services with regional scope became more significant. Estimated coverage reached 53.9% of the population in 2009, in 20.5% of Brazilian municipalities. Implementation varied between States, and there were less advanced support ambulances than recommended, both nationally and in several States.
Conclusions:
SAMU was adopted nationwide since 2003 upon development of federal norms. Implementation of the policy involves challenges, including adequate investment, integration of the service into an established urgent care network, arrangement of appropriate information systems and personnel capacity. Addressing these challenges will allow SAMU to become a key health care strategy in the unified health system.
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