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Care coordination through primary health care and network integration: the importance of ensuring comprehensive and integrated care in the Brazilian Unified National Health System

Year: 2026

Type: article

Abstract: Care coordination and the integration of primary health care (PHC) within the health care network are structural challenges to achieving comprehensive care in the Brazilian Unified Health System (SUS). This article analyzes the prevalence of instruments, strategies and mechanisms for care coordination and health service regulation in basic health units (BHU), as well as their association with contextual and structural factors. Results from the 2024 Brazilian National Basic Health Units Census (BHU Census) were analyzed, covering 43,254 units with PHC teams, based on the following components: coordination, network integration, health service regulation mechanisms and shared care. Communication between services occurred predominantly through informal means, while the use of email and interoperable electronic health records was more limited. Referrals through the regulation system took place in about two-thirds of BHU, alongside other pathways under the patient's responsibility. Electronic health records were widely implemented in BHU, but inadequately shared with other health facilities in the network. Care coordination was stronger between BHU, Psychosocial Care Centers and hospitals. The presence of management within BHU was associated with more frequent and formal communication, as well as greater use of coordination instruments. The findings highlight the need to advance structural policies that establish PHC as the coordinator of care, with investments in digital infrastructure, interoperability of information systems, strengthening of managerial capacity and recognition of multiprofessional work, in order to expand service effectiveness and reduce socio-spatial inequalities.

Source: Cadernos de Saúde Pública

DOI: 10.1590/0102-311xen226625

Authors: Patty Fidelis de Almeida, Simone Schenkman, Aylene Bousquat, Elisandréa Sguario Kemper, Ligia Giovanella

Institutions: Universidade Federal Fluminense, Universidade de São Paulo, Ministério da Saúde, Fundação Oswaldo Cruz

Language: English

Topic: Healthcare Systems and Technology

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funders: Conselho Nacional de Desenvolvimento Científico e Tecnológico, Ministério da Saúde