title: [Pediatric practice in public emergency services and factors affecting care].
abstract: This qualitative empirical study discusses the material and organizational conditions of work by pediatricians in a public emergency service, with the aim of identifying factors that affect care. The work was studied using group interviews and direct observation in the emergency unit. The results were compared with statistical and historical data from documental research. Forty-four pediatricians from seven teams were interviewed, and seven of the pediatricians were observed while on duty. The precarious referral and counter-referral system was a determinant factor leading to the heavy demand on the emergency unit. Agglomeration of patients and families at the entrance to the emergency service led to time pressure and interfered directly in the pediatric care. The study identified informal strategies devised and implemented by these physicians in attempts to guarantee the quality of care in keeping with pediatric principles.
authors.affiliation: Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, MG 30310, Brazil. egleamelo@uol.com.br
authors.forename: Egléa Maria da Cunha
authors.initials: EM
authors.lastname: Melo
authors.forename: Ada Avila
authors.initials: AA
authors.lastname: Assunção
authors.forename: Roberto Assis
authors.initials: RA
authors.lastname: Ferreira
mesh_terms: D001938:Brazil; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007407:Interviews as Topic; D010372:Pediatrics / Q000458:organization & administration / Q000592:standards*; D011635:Public Health Administration; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation
vernacular_title: O trabalho dos pediatras em um serviço público de urgências: fatores intervenientes no atendimento.