The universalization of actions and services, promoted by the SUS, has been characterized as exclusionary and accompanied by rationalization of funding and inclusion of all people in public health care. This study analyzes the policy hierarchy of SUS as a mechanism for planning, through the institutional and professional practices developed in the Regulation Center. The goal is to understand and analyze the social representations of actions and access to health services by technicians and managers in these centrals in the city of Rio de Janeiro. The field of study was the Emergency Regulation Center and State Regulation of Beds. We interviewed 20 subjects and employed content analysis. The results highlight the following representational categories: the attitude of the organization and flow to access, roles and practices of regulation, fragmentation of the autonomy of regulation, determining the relationship network access, and no single command. The fragility of the public health system has exposed itself, and practices in the regulation center are ineffective and dependent on non-formal mechanisms of action. There is a less consolidated SUS in Rio de Janeiro when compared to municipalities experiencing that advance in a unified manner, regionalized and hierarchical access to the actions of SUS. It is noteworthy that the regulation centers are privileged spaces for observation of the system and can take effective action and agile, facilitating access to services and providing a sensitive channel to meet the health demands of the population.
Brazilian Public Health System; Social representation; Health Policy