Reflexos de um processo de qualificação da Atenção Primária à Saúde na rotina e no cuidado produzido por seus trabalhadores

Beraldi, Mariana Lectícia; Mendonça, Fernanda de Freitas; Carvalho, Brí­gida Gimenez; Félix, Sarah Beatriz Coceiro Meirelles

doi:10.1590/s0103-73312021310112

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…This not only confirms that the similarity with results obtained by Group 2 (ÀP4P/þP4P) may be justified by other municipal management and team actions developed across the cycles but also seems to indicate a limit for continuous improvement of service quality when high scores are achieved, as observed in Groups 3 (þP4P/þP4P) and 4 (þP4P/ÀP4P). IJPSM 36,6/7 Beraldi et al (2021) highlighted the physical and mental strain of workers in their attempts to comply with PMAQ indicators and improve primary care quality, including frustration due to the considerable shortage of human resources and materials in some health services. In some situations, this scenario led to questionable strategies on the part of managers and professionals, such as relocating equipment and materials from other health units to meet program requirements during external evaluation.…”

Section: Discussionmentioning

confidence: 99%

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Pay for performance in Brazilian primary health care: quality of work processes, actions and services

Anjos

Scherer

Cantalino

et al. 2023

IJPSM

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PurposeIn 2011, Brazil introduced a national pay-for-performance (P4P) scheme called the National Program for Improving Primary Health Care Access and Quality (PMAQ), rolled out over three cycles and reaching more than 5,000 municipalities and 40,000 family health teams (FHTs). There is little evidence on how the PMAQ was implemented locally and whether this variation in implementation affects performance, particularly, in terms of work process indicators. This study compared different cases of municipal-level PMAQ implementation (bonuses paid or not to FHTs) over the last two program cycles to analyze the quality of the work processes, actions and services of FHTs.Design/methodology/approachThis was a cross-sectional analytical study using secondary data from an external evaluation of the Brazilian PMAQ. In total, 27,500 FHTs participated in the evaluation. They were divided into four clusters based on whether or not municipalities paid bonuses to workers during cycles 2 and 3 of the program (2013–2019). Variables regarding work processes, actions and services were classified as “Quality Assurance – QA” or “Continued Quality Improvement – CQI”, and an individual score was assigned based on the average score of each variable.FindingsThe four clusters displayed an increase in overall QA and CQI scores between the two program cycles; though this increase was small between the set of primary health care teams that received bonuses and those that did not.Originality/valueThis paper contributes to bridging the gap in the scientific literature for evaluative studies on the relationship between direct payment for performance to health professionals and better quality actions and services in low and middle-income countries.

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Section: Discussionmentioning

confidence: 99%

“…Beraldi et al. (2021) highlighted the physical and mental strain of workers in their attempts to comply with PMAQ indicators and improve primary care quality, including frustration due to the considerable shortage of human resources and materials in some health services.…”

Section: Discussionmentioning

confidence: 99%

Pay for performance in Brazilian primary health care: quality of work processes, actions and services

Anjos

Scherer

Cantalino

et al. 2023

IJPSM

View full text Add to dashboard Cite

show abstract

“…Quanto a busca ativa por qualificação profissional, a constatação das recorrentes vivencias em cursos de especialização traz à tona a notória necessidade de atualização dos recursos humanos do SUS, corroborando com Beraldi et al (2021), que descreve a compreensão do processo de qualificação de trabalhadores da APS por meio de dois grandes benefícios ao SUS: organização do processo de trabalho e mecanismo de captação financeira condizente com o interesse público.…”

Section: Motivações Relacionadas Ao Curso De Especializaçãounclassified

Programa de Especialização em Educação para a Saúde: Avaliação das Contribuições para a prática Profissional na Atenção Primária à Saúde

et al. 2022

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O atual cenário da saúde pública demanda mecanismos de qualificação de profissionais atuantes na Atenção Primária à Saúde (APS), como os programas de especialização, almejando a reordenação dos processos de trabalho no SUS. Nessa perspectiva do alcance de competências para as reais necessidades coletivas, este estudo tem o objetivo de analisar as contribuições de um programa de especialização em educação para saúde à prática profissional na APS. Trata-se de estudo descritivo, quantitativo e de corte transversal, com amostra composta por 20 discentes. Foram coletados dados sociodemográficos e profissionais e utilizadas duas escalas validadas: Escala de Expectativa em Relação ao Treinamento e Escala de Motivação para Transferir. A análise dos dados se deu por meio da estatística descritiva de frequências absoluta e relativa. No perfil discente, constatou-se a prevalência do público feminino (95%), de 30 e 49 anos (75%), com ao menos uma especialização concluída (95%) e 5 anos de formação (75%). Ademais, 75% dos respondentes atuam na APS, com 80% discentes contratados. A categoria de enfermagem apresentou a maior representação (55%). Em função da capacidade laboral, 95% dos discentes sempre desenvolvem atividades educativas, mesmo com limitado incentivo dos gestores para a realização das práticas educativas (75%) e para a qualificação profissional (45%). A especialização mostrou-se relevante para a APS, estimulando os discentes a utilizarem competências adquiridas, com aumento da qualidade das ações desenvolvidas, tornando-as mais fáceis, com minimização de erros, através da eficiente mudança no perfil gerencial e do fortalecimento do trabalho em equipe para a superação de eventuais barreiras.

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Laying the Foundations of Continuing Education in Health in the Family Health Strategy

et al. 2022

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Primary healthcare must guarantee health and well-being for the community as a whole, ensuring equity and quality in different responses. For this goal to be achieved, teams must be trained and integrated, and service flows must be functional. Continuing education in health, as a form of training professionals in the workplace, helps to center responses around the needs and preferences of people and families, and to balance the fulfillment of demands by using better work management as a starting point. The objectives of the present qualitative study were to elucidate the meaning given by health professionals who developed their activities in the Family Health Strategy in order to continue education in health, and to discuss the qualification and structuring of work management with this type of education as a background. The methodology used was Straussian grounded theory. Thirty professionals in four Brazilian health units who had experience in the family health field participated in the study. Data were collected between June 2018 and May 2019. Based on three categories, the emerging substantive theory was as follows: laying the foundations of continuing education in health in a collective dialogic and dialectical effort to contribute to the qualification of the work processes in the Family Health Strategy. The professionals’ accounts showed that they recognize the importance of continuing education in health and the need to discuss it, given its potential to transform and to assist in the education of professionals with autonomy in the management of their work processes.

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Reflexos de um processo de qualificação da Atenção Primária à Saúde na rotina e no cuidado produzido por seus trabalhadores

Cited by 3 publications

References 8 publications

Pay for performance in Brazilian primary health care: quality of work processes, actions and services

Pay for performance in Brazilian primary health care: quality of work processes, actions and services

Programa de Especialização em Educação para a Saúde: Avaliação das Contribuições para a prática Profissional na Atenção Primária à Saúde

Laying the Foundations of Continuing Education in Health in the Family Health Strategy

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