title: [Specialized outpatient care in the Unified Health System: how to fill a void].
abstract: The structuring of specialized outpatient care is a bottleneck in the operation of the Unified Health System. Based on a brief discussion about this void in an organizational model, we propose the federal induction of a format of specialized services from the experiences of Centers of Support for Family Health (NASF). They adapted matrix operations and constitute an excellent prototype for the organization of specialized outpatient care. It allows for equal access and maximum proximity to the specialized care of the reality of primary care users, the personal relationship and the close relationship between the family health teams and medical and non-medical specialists, enabling mutual lifelong learning, negotiated regulation and increased efficacy of primary care. Municipal experiences of Florianopolis and Curitiba are synthesized as partial examples of the proposal. the structure of care in mental health of Florianópolis, all organized as a matrix support is briefly described; and we focus on the change in the action of the support teams of Curitiba, which gradually began to engage, involve and mediate the relationship between basic and specialized care. This format can be expanded to most medical specialties.
authors.affiliation: Departamento de Saúde Pública, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina. Campus Universitário/Centro de Ciências da Saúde, Trindade. 88040-900 Florianópolis SC Brasil. charles.tesser@ufsc.br.
authors.forename: Charles Dalcanale
authors.initials: CD
authors.lastname: Tesser
authors.affiliation: Departamento de Saúde Comunitária, Universidade Federal do Paraná. Curitiba PR Brasil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Poli
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration*; D001938:Brazil; D005192:Family Health; D006297:Health Services Accessibility; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D013038:Specialization