Managing the transition from primary care to tertiary health services: a systematic review on the importance and effectiveness of the manager's role

Abstract

The transition between primary care and tertiary health services is a complex challenge for health management, which requires efficient coordination to ensure continuity of care and achieve better outcomes for patients. This integration between levels of care is essential for both the sustainability of the system and user satisfaction. This study focuses on exploring the role and responsibilities of health managers in this process, analyzing effective management practices and the main obstacles faced in the integration of services. A systematic review of the literature was carried out, covering articles, reports, and public policy guidelines published between 2008 and 2022. The databases used were PubMed and Scielo, with descriptors such as "transition management", "primary care", and "tertiary health service". Theoretical articles, reviews, and relevant empirical studies were included; texts without full access, not written in Portuguese, that did not address the role of the manager, or that presented low methodological relevance were excluded. Data analysis combines qualitative and quantitative methods to examine management strategies, barriers, and impacts of the transition. The study respected ethical aspects, ensuring confidentiality and appropriate use of information. The results show that managers have an essential role in coordination and communication between the different levels of care. Strategies such as the implementation of integrated information systems, ongoing training for professionals, and well-defined protocols are crucial for the success of the transition. However, challenges such as lack of resources, resistance to change, and fragmentation of services hinder the effectiveness of the transition. Effective management of this process is essential to improve continuity of care and clinical outcomes. To address these challenges, managers must prioritize strategies for integration, training, and clear communication, ensuring quality care.