[Dilemmas in regulating access to specialized care for children with complex chronic health conditions]

The scope of this article was to analyze the access of children with complex chronic health conditions to specialized care, identifying their strengths and weaknesses from the perspective of speech therapists. The selection of research subjects was made considering the participation in a virtual group whose dynamics signaled the difficulty of members, municipal civil servants, in the conduct of referring patients to health services. Face-to-face interviews were conducted with 14 speech therapists from this group who work with children. The study of the difficulties faced by the interviewees made it possible to identify that care via the Regulation System is an aggravating factor in difficulties of access. In this respect, the problems mentioned were grouped into three topics: (1) Waiting time for making appointments; (2) Distance from the care centers; and (3) Misconceptions in the referral process. In addition, the work of the Expanded Family Health and Primary Care Service was identified as a relevant factor in facilitating children's access to specialized care services in partnership with regulation. The conclusion drawn is that the presence of mediators in health care benefits the population with difficulty of access to services, including children with complex chronic health conditions.