Transition between Primary and Specialized Care in monitoring systemic arterial hypertension: restricted access and discontinuous care

Abstract

This study aims to analyze access to specialized care  and continuity of care in the experience of users with systemic arterial hypertension in the transition between levels of care. An evaluation study was carried out based on interviews with users referred to specialized care by primary health care. From the thematic analysis, three moments were identified that reflect participants’ experiences The first is the request for a “referral for specialized care,” identified by users as “documents,” which obstruct access to therapeutic support and generates dissatisfaction with primary health care. To “access specialized care,” users and family members forged different strategies, parallel or complementary to the use of public services. The barriers were more significant for specialized exams: around ¾ of users sought them in the private network, especially in popular clinics. The “continuity of care” dimension offered no communication between care levels, users transmitted clinical information, compromising the coherence of care and fraying bonds, which neither primary health care nor specialized care established. The experiences of transition between levels shows restrictions and mitigation of full access to health with impacts on credibility and satisfaction with the public health system.