Dimensões da qualidade na avaliação em saúde: concepções de gestores

Abstract

The conceptions of managers responsible for the planning of basic health care at the state level revealed an important disassociation from the premises of qualitative evaluation, especially those evaluations oriented by the fourth generation approach. Therefore, the model adopted by these actors for the evaluation of program and service quality did not consider their multidimensionality.

Primary health care as assessed by health professionals: comparison of the traditional model versus the Family Health Strategy

“…The performance of the PHC was measured by the PCATool designed for managers and health professionals 7,[16][17][18] . It contains approximately 100 questions, divided into eight attributes (accessibility, longitudinality, comprehensiveness, family focus, professional formation, first-contact, coordination and community orientation [7][8][9]12,16,17,21 ), containing a variable number of questions. Within each attribute, respondents must answer on an increasing six-point Likert-type scale ranging from 0 (never) to 5 (always), with the exception of two questions on the accessibility attribute which adopt a decreasing scale and must therefore be converted for analysis.…”

“…Based on evidence that high-quality PHC may have a positive impact on health indicators 7 , it follows that an innovative PHC model should provide better health outcomes. Comparative performance assessments of the FHS and traditional models by users, health professionals and managers have been carried out [8][9][10][11][12][13][14][15] . Quality-related key elements have been taken as a reference and adapted to the reality of the PHC in Brazil by validation with the Primary Care Assessment Tool (PCATool) 7,[16][17][18] .…”

Gestão do Sistema de Saúde do Município de São Paulo com Base nos Parâmetros de Avaliação do PMAQ-AB: Estudo de Casos na Microrregião de Cidade Tiradentes

“…Como identificado por Bosi et al (2010), as concepções do grupo concernentes ao conceito qualidade não se mostram claras, a qualidade dos programas se expressa, sobretudo, em sua dimensão objetiva, imprimindo a perspectiva da quantificação, ou seja, da avaliação tradicional, considerando-se, muitas vezes, esse tipo de avaliação como avaliação qualitativa. Desse modo, todos os gestores também identificam maiores esforços no processo de melhoria do acesso e acreditam que a melhoria da efetividade ainda é um dos grandes desafios da gestão, não havendo clareza quanto ao método a utilizar para avaliação e monitoramento quando se trata da efetividade e sua dimensão qualitativa (Bosi, Pontes, & Vasconcelos, 2010).…”

“…Desse modo, todos os gestores também identificam maiores esforços no processo de melhoria do acesso e acreditam que a melhoria da efetividade ainda é um dos grandes desafios da gestão, não havendo clareza quanto ao método a utilizar para avaliação e monitoramento quando se trata da efetividade e sua dimensão qualitativa (Bosi, Pontes, & Vasconcelos, 2010).…”

Quality evaluation: users’ satisfaction of obstetric and mixed pediatric intensive care unit

“…However, in this case, the quality is not the subject, but rather, an adjective of the evaluation process. 2 Thus, it is necessary to use quality evaluation as a tool in the search for care improvement in any environment where it is performed, having strong expansion possibilities in the context of Pediatric, Neonatal and Obstetric Intensive Care Units, because professional behavioral changes have occurred involved in these sectors, which a model of care focused on child and family has adopted, based on a philosophy of modern assistance. …”