Abstract
The National Policy of the Emergency Department (PNAU) aims to mediate primary care and medium and high complexity services. Which is the theme of this article’s research, that aimed to identify the main difficulties of PNAU agreed management in two main cities of the metropolitan region of Belém, Pará, Brazil. This is a basic qualitative research, which used documents and semi-structured interviews with the main managers of both the policy and control and supervision institutions. The results indicate federative coordination difficulties that impose four constraints to the policy to be efficient: centralization, cooperation, financing, and agreement. We conclude that decentralization in the health area is still not efficient when it comes to the national policy of urgency and emergency, due to the difficulties that federal entities face with the required pacts and political issues present in planning and management.
Keywords:
Federalism; Coordination; Health policy; Urgency and emergency