[Public outpatient clinics in the city of São Paulo, Brazil: operational conditions and repercussions on primary care in the Unified National Health System, 2006].
In the process of building the Unified National Health System (SUS) as a comprehensive, universal policy in Brazil, an essential element (and unmet challenge) is to serve the demand for treatment without previously scheduled appointments, as part of upgrading primary care. In 2005, the São Paulo Municipal Health Department began implementing so-called outpatient medical care units (AMA), aimed at establishing an alternative to primary care units for meeting this demand. The aim of the current study was to verify the operating conditions of these new medical services and their repercussions on primary care in the SUS, in relation to the principles of universal, comprehensive, seamless care. A cross-sectional descriptive study was developed on the basis of data from secondary sources pertaining to outpatient services in the city of São Paulo and the conditions for the organization and functioning of the existing AMA units in 2006. These units display various structural and operational inadequacies, and the role they play in the health care model fails to confirm a positive impact on valuing primary care in keeping with the principles and strategies of the SUS.