Health Care Network for the Elderly – RASPI

(V.D.04) Healthcare

The Technical Area of Health for the Elderly has the mission of formulating and developing actions, projects, and programs aimed at preventing and promoting the health of the elderly population, both individually and collectively, with a qualified look at their socioeconomic conditions and their capacity for self-care, through the organization of a comprehensive health care network, in line with the principles of the SUS and based on the guidelines of the National Health Policy for the Elderly.

The Health Care Network for the Elderly – RASPI, in turn, has as its main axis the assessment of functional capacity in Primary Care using a screening instrument that is the Multidimensional Assessment of the Elderly in Primary Care (AMPI-AB) which classifies the elderly as healthy, pre-frail and frail. This instrument is discussed by the Primary Care equipment teams, who must prepare a care plan (Singular Therapeutic Plan – PTS), according to the needs of each evaluated elderly person. The elderly classified as healthy and pre-frail are followed up at the UBS, while the elderly classified as frail must be followed up in specialized care, with the Health Reference Unit for the Elderly – URSI. Other referrals to specialists and diagnostic tests also occur, as needed.

Official Name of Signatory

City of Sao Paulo

Delegation

Brazil

Website of the Signatory

Name of the person presenting the Good Practice

Lucas Roberto Paredes Santos

Position/Job Title of person presenting the Good Practice

Assessor International Relations

Aim of the Good Practice

Guarantee the promotion and integral attention to the health of the elderly, so that they remain in the community for as long as possible and with the highest attainable functional capacity.

Target Group of the Good Practice

Elderly population in the city of São Paulo

Implementation period

Continuous Action

Consistency over time

Continuous Action

Evaluation of the Good Practice

It is carried out by the Technical Area of Health for the Elderly Population, but the office monitors the implementation of new actions through the SUS management instruments, such as the Annual Management Report.

Key stakeholders and partnerships

Regional Health Coordinations, Health Units and Health Reference Units for the Elderly

Link for more information