<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1981-5271</journal-id>
<journal-title><![CDATA[Revista Brasileira de Educação Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. bras. educ. med.]]></abbrev-journal-title>
<issn>1981-5271</issn>
<publisher>
<publisher-name><![CDATA[Associação Brasileira de Educação Médica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1981-52712015000300359</article-id>
<article-id pub-id-type="doi">10.1590/1981-52712015v39n3e01542014</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Desafios Organizacionais para Fortalecimento da Atenção Primária à Saúde em Portugal]]></article-title>
<article-title xml:lang="en"><![CDATA[Organizational challenges in strengthening Primary Health Care in Portugal]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[Adriano Maia dos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Giovanella]]></surname>
<given-names><![CDATA[Ligia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Botelho]]></surname>
<given-names><![CDATA[Henrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sousa]]></surname>
<given-names><![CDATA[Jaime Correia de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade Federal da Bahia  ]]></institution>
<addr-line><![CDATA[Vitória da Conquista BA]]></addr-line>
<country>Brasil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>07</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>07</month>
<year>2015</year>
</pub-date>
<volume>39</volume>
<numero>3</numero>
<fpage>359</fpage>
<lpage>369</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://educa.fcc.org.br/scielo.php?script=sci_arttext&amp;pid=S1981-52712015000300359&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://educa.fcc.org.br/scielo.php?script=sci_abstract&amp;pid=S1981-52712015000300359&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://educa.fcc.org.br/scielo.php?script=sci_pdf&amp;pid=S1981-52712015000300359&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMOEste artigo analisa os principais aspectos da Reforma da Aten&#231;&#227;o Prim&#225;ria &#224; Sa&#250;de (APS) em Portugal, que culminaram na implanta&#231;&#227;o das Unidades de Sa&#250;de Familiar (USF), amplia&#231;&#227;o do acesso e melhoria no processo de coordena&#231;&#227;o dos cuidados. Identifica avan&#231;os e limites da reforma na APS portuguesa, que, apesar do contexto social e hist&#243;rico distinto, podem subsidiar as pol&#237;ticas de sa&#250;de no Brasil. Realizou-se um estudo de caso com abordagem qualitativa, em Portugal, elegendo-se quatro USF na Regi&#227;o Norte, uma USF na Regi&#227;o de Lisboa/Vale do Tejo e dois Agrupamentos de Centros de Sa&#250;de (Aces) na Regi&#227;o Norte. Foram realizadas 20 entrevistas semiestruturadas, com observa&#231;&#227;o sistem&#225;tica e an&#225;lise documental. O sucesso da reforma destaca-se na dimens&#227;o micropol&#237;tica, ou seja, na cria&#231;&#227;o das USF como processo volunt&#225;rio de ades&#227;o dos profissionais de sa&#250;de, o que permite certa estabilidade mesmo em tempos de crise. A Reforma da APS em Portugal &#233; considerada um &#8220;evento extraordin&#225;rio&#8221;, um exemplo bem-sucedido de interven&#231;&#227;o nas reformas organizacionais na Europa em favor da coordena&#231;&#227;o dos cuidados por m&#233;dicos generalistas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACTThis article examines key aspects of Portugal&#8217;s primary health care (PHC) reform, which culminated in the introduction of family health clinics (Unidades de Sa&#250;de Familiar, USF), expanded access and improved care coordination processes. It aims to identify advances and constraints on PHC reform in Portugal which, despite the differences in social and historical context, may serve to inform health policies in Brazil. A qualitative case study was conducted in Portugal at four USFs in the Lisbon/Vale do Tejo region and two health centre clusters (Agrupamentos de Centros de Sa&#250;de, ACES) in the North region. The data collection techniques comprised twenty semi-structured interviews, systematic observation and documentary analysis. The reform was particularly successful at the micro-policy level, that is, in introducing USFs as a process which health professionals could join voluntarily, which afforded a certain stability even in times of crisis. Portugal&#8217;s PHC reform is considered an &#8220;extraordinary event&#8221;, an example of successful intervention in organisational reforms in Europe to promote coordinated care by general practitioners.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Atenção Primária à Saúde]]></kwd>
<kwd lng="pt"><![CDATA[Acesso aos Serviços de Saúde]]></kwd>
<kwd lng="pt"><![CDATA[Integração de Sistemas]]></kwd>
<kwd lng="pt"><![CDATA[Controle de Acesso]]></kwd>
<kwd lng="pt"><![CDATA[Medicina de Família e Comunidade]]></kwd>
<kwd lng="pt"><![CDATA[Estratégia Saúde da Família]]></kwd>
<kwd lng="pt"><![CDATA[Continuidade da Assistência ao Paciente]]></kwd>
<kwd lng="pt"><![CDATA[Educação Médica]]></kwd>
<kwd lng="en"><![CDATA[Primary Health Care]]></kwd>
<kwd lng="en"><![CDATA[Health Services Accessibility]]></kwd>
<kwd lng="en"><![CDATA[Systems Integration]]></kwd>
<kwd lng="en"><![CDATA[Gatekeeping]]></kwd>
<kwd lng="en"><![CDATA[Family Practice]]></kwd>
<kwd lng="en"><![CDATA[Family Health Strategy]]></kwd>
<kwd lng="en"><![CDATA[Continuity of Patient Care]]></kwd>
<kwd lng="en"><![CDATA[Medical Education]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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