O CUIDADO DAS CONDIÇÕES CRÔNICAS NA ATENÇÃO PRIMÁRIA À SAÚDE

Health conditions can be defined as circumstances in people’s health which are more or less persistent and which require reactive or proactive, episodic or continuous and fragmented or integrated social responses from health care systems, health professionals and health care users. The finding that the classic typology of communicable diseases and noncommunicable diseases cannot support the organization of health care systems led to the proposal of health conditions, which was developed in the late 1990s by scholars linked to the chronic care model(1,2) and then adopted by the World Health Organization(3). Knowing such conditions allows to know them better and thus be able to prevent possible diseases through health promotion strategies. The study of the typology of health conditions is based on the way health professionals, health care users and health care systems are engaged to respond socially to the demands, whether in a reactive, episodic and fragmented way, or in a proactive, continuous and integrated way. Such typology is mainly based on some key variables contained in the concept of health condition: the first refers to the duration of the health condition – short or long; the second is the way health professionals, health care systems and health care users fight such conditions – an episodic, reactive and fragmented approach focused on diseases and complaints or a continuous, proactive and integrated approach focused on people and families through more or less permanent care contained in a plan of care prepared by the health team and the users together. It should be noted that chronic condition is not the same as chronic disease. All chronic diseases (diabetes, cardiovascular diseases, cancers, chronic respiratory diseases, chronic musculoskeletal diseases, and others) are chronic conditions. But this concept also encompasses persistent infectious diseases (leprosy, tuberculosis, HIV/AIDS, certain viral hepatitis, and others), maternal and perinatal conditions (follow-up of pregnant women and perinatal, postpartum and newborn care); conditions linked to the maintenance of health throughout life cycles (child care, adolescent care and older person care); long-term mental disorders; continuous physical and structural disabilities (amputations, blindness, persistent motor deficits, and others); metabolic diseases; non-acute oral diseases; and health conditions characterized as illnesses, which refer to the way people perceive their disease, that is,