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em CiencIPCA - Instituto Politécnico do Cávado e do Ave, Portugal


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The National Health Service is one of the portuguese social progress pillars and as a key role in terms of health services, organized around a universal service, general and tend to free, provided for the Portuguese Republic Constitution, in order to promote people's access to health care,adequate and adaptively to their needs and expectations, seeking economic efficiency in a control context of public expenditure and budget. Primary Health Care are considered fundamental piece for the National Health Service, as they are the first users accessibility to health care, being the health center a unit to serve and providing the essential first treatments, preventive and/or curative, assuming important functions of promotion of health and prevention of disease, cooperating with other services for continuity of caring. The implementation of the Health Centers Groupings aims to decentralize the management and allow decision making on key resources to the provision of care, absorbing the district offices of the extinct Health Sub-Regions and having the task of ensuring the provision of health care primary the population of a given geographical area, based on a multidisciplinary team with organization and technical autonomy and is guaranteed intercooperation with other functional units. However, these district offices were attached to the Regional Health Administrations following the reverse path, causing dysfunctional positions and making health centers Groupings their dependents. Thus, before the reform of Primary Health Care, all the structural changes were made, except to check the Health Centers Groupings proper management autonomy, currently one of the biggest obstacles to the implementation of such reform. It is intended in this work through a inquiry by forms done at 21 Health Centers Groupings North Regional Health Authority, IP, evidence can the management autonomy in Health Centers Groupings provide greater efficiency in the provision of Primary health Care to citizens and ensure greater sustainability of the National health Service, better managing existing resources, human and financial, showing a growing responsibility in its management and ensuring appropriate practices, more quality in health care and better accessibility, providing the ability to apply more adjusted measures in providing health care to the population of their geographical área.