Box 3. Additional statements of managers by analytical category.
| Category | Illustrative statements | Analytical synthesis |
|---|---|---|
| Implantation and expansion of emergency care units (UPA) | "The value that the ministry of health and the state will give … this cost is still very high for the municipality" (E13) | Federal underfunding |
| "The state is not interested. I think the pre-hospital service it has is enough and one more component, the UPA, will not change much" (E9) | Rejection of the state | |
| "I see the UPA as an evolved model of the emergency care that had no resolutiveness. From physical space, team qualification, equipment, medication, the UPA model is more appropriate" (E7) | Acceptance of the state | |
| Structural conditions for care | "Well structured, they improved the working conditions of professionals" (E5) | Good structural conditions |
| "We have UPA that are much better than the urgency of the hospital" (E24) | ||
| "Lack of pediatrician, serious problem" (E13) | Lack of medical professionals | |
| The UPA and other components of the emergency network | "In the countryside, small municipalities have 100% of coverage of the FHS, but the doctors attends once, twice a week" (E6) | Difficulty in relation to primary care |
| "The state wanted to have ICU beds in the UPA" (E5) | Lack of hospital beds | |
| "Mirror Hospital - metropolitan reference hospital with SH or philanthropic hospital that integrate each other to define pharmacy, bed rotation, etc." (E11) | Strategies to cope with difficulties in hospital management | |
| Management of UPA and interaction between federated entities | "Regional UPA does not make sense. All municipalities have a small hospital that has to solve more than the UPA. The municipality ceases to invest in a service for it to invest in another regional hospital that does not have great resolutiveness. It would be different if it were a specialized regional hospital that would solve more than the municipality is capable" (E9) | Difficulty of agreement between municipalities |
| "The municipality asked for an UPA in 2009, but gave up and returned the appeal. The state is resisting assuming it because the pre-hospital park it has is enough" (E6) | Difficulty of agreement between municipality and state |
FHS: Family Health Strategy; ICU: intensive treatment unit; SH: small hospital