title: [Management practices of regional referencing: a comparative study of five cases in the State of São Paulo, Brazil].
abstract: OBJECTIVE
  To evaluate management practices of regional referencing in the State of São Paulo, identifying the main difficulties in the process of agreement between health managers to achieve integrate health care.
  
  
  METHODS
  5 regions were selected (CPN-Campinas, Piracicaba-PRC, MC-Mogi das Cruzes, São José do Rio Preto-SJRP and Sao Jose dos Campos-SJC) in which were analyzed: indicators of 4 lines of care (Hypertension-HA and Diabetes Mellitus-DM, Mental Health, Oral and Women), the working tools of referencing and perceptions of regional and municipal managers on the process.
  
  
  RESULTS
  the performance of managers regarding the scope of the universality and comprehensiveness of care was analyzed through 11 indicators, resulting in a score ranging from 0 to 5. The classification of the regions was: SJRP (4.55), CPN (2.91), SJC (2.27), PRC (2.27) and MC (1.91). The analysis of interviews with managers revealed that the formal mechanisms of listings are insufficient, and the tools for its monitoring, in metropolitan areas seems to be more difficult for agreement of references, the strengthening of spaces for negotiation between the managers was identified as a factor facilitating the process.
authors: Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, 01314-000, Brazil. soniav@isaude.sp.gov.br
authors: Sonia Isoyama
authors: SI
authors: Venancio
authors: Paulo Roberto
authors: PR
authors: do Nascimento
authors: Teresa Etsuko
authors: TE
authors: Rosa
authors: Maria de Lima
authors: Mde L
authors: Salum e Morais
authors: Patrícia Nieri
authors: PN
authors: Martins
authors: Anna
authors: A
authors: Voloschko
mesh_terms: D001938:Brazil; D003695:Delivery of Health Care / Q000458:organization & administration*; D006801:Humans; D012040:Regional Health Planning / Q000458:organization & administration*