Institutionalization of care practices for chronic conditions and the management of assistance in Primary Health Care* * This article derives from a Doctoral dissertation in Collective Health carried out at Universidade do Vale do Rio dos Sinos (Unisinos).

Cassiane Silocchi José Roque Junges Vilene Moehleck Margarita Silva Diercks About the authors

The purpose of this study was to analyze the institutionalization of care practices for chronic conditions and the management of assistance in a primary care service. The socio-analytical line of Institutional Analysis was chosen as the theoretical-methodological framework. In this intervention research, participant observation, groups held with health teams and interviews conducted with the individuals responsible for developing research and evaluating the service were used as tools. The results show that the subject’s resistance to change is an obstacle to the development and consolidation of the care practices for chronic conditions. In addition, there is not a collective responsibility of all the professionals, demonstrating the lack of planning and engagement of the team. Also worthy of note is the results-oriented management policy, which oppresses and discourages collective power and innovation.

Keywords
Institutional Analysis; Chronic disease; Work process; Primary Health Care


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