Care coordination through primary health care and network integration: the importance of ensuring comprehensive and integrated care in the Brazilian Unified National Health System
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.
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BibTeX
@article{almeida2026care,
title = {{Care coordination through primary health care and network integration: the importance of ensuring comprehensive and integrated care in the Brazilian Unified National Health System}},
author = {Patty Fidelis de Almeida and Simone Schenkman and Aylene Bousquat and Elisandréa Sguario Kemper and Ligia Giovanella},
journal = {Cadernos de Saúde Pública},
year = {2026},
month = nov,
doi = {10.1590/0102-311xen226625},
url = {https://doi.org/10.1590/0102-311xen226625},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Care coordination through primary health care and network integration: the importance of ensuring comprehensive and integrated care in the Brazilian Unified National Health System
AU - Patty Fidelis de Almeida
AU - Simone Schenkman
AU - Aylene Bousquat
AU - Elisandréa Sguario Kemper
AU - Ligia Giovanella
PY - 2026
DA - 2026/11/02
JO - Cadernos de Saúde Pública
DO - 10.1590/0102-311xen226625
UR - https://doi.org/10.1590/0102-311xen226625
AB - 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.
SN - 1678-4464
SN - 0102-311X
ER -