Modelos de organização da assistência farmacêutica na atenção ambulatorial: Uma análise comparada

The objective of this text is to identify different models of organization of pharmaceutical services (PS) in outpatient care and factors that influence this organization. A comparative analysis of the forms of PS organization in outpatient care adopted by 25 countries was carried out. To do so, the theoretical model proposed by the Pan American Health Organization (Paho) was based on the factors that influence its organization. For the characterization of the models, a table was elaborated that summarizes the relations between the main functions to be performed and the structures, policies and processes commonly used by the countries. Two factors that influence the models were investigated for being considered more relevant and for the availability of information, health policy and financing. The relationship between having a cooperation agreement with the World Health Organization (WHO) and the implementation of a specific model was also analyzed. Public documents and data were used to prepare the description of the PS organization in each country. These descriptions were processed with the support of the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (Iramuteq) software, enabling the identification of three different models of PS organization. A logistic regression analysis was performed using the RStudio software, finding as a predictor variable of one of the models the national per capita income in dollars per purchasing power parity (PPP). It is concluded that there are similarities in the execution by countries of various functions related to PS. However, differences related to the financing of medicines, the management of the logistics and the dispensation of medicines generate the three identified models, with the country's income being a relevant factor in determining the adoption of one of them.