“…The process of FHS implantation in Brazil was carried out with difficulties related to the application of financial resources, lack of professionals and lack of commitment from many cities with the primary care proposal 8,13,17 . Financing related to population coverage led to the faster expansion of FHS in smaller cities 17 , but there were difficulties and insufficient coverage in large urban centers 18 . Besides, the heterogeneity of Brazilian States, especially concerning dimension, economic resources, access, availability of professionals and investments, and the political implication, also made it difficult to implement the FHS in Brazil 13 .…”
ABSTRACT:Objective: To evaluate the relationship between hospitalization due to conditions that are sensitive to primary care and the population coverage by the Family Health Strategy (ESF) Units of the Brazilian Federation Units in the last decade. Methods: This is an ecological study that investigated preventable hospitalizations and coverage of primary health care in Brazil in the historic series from 1998 to 2006. Statistical analysis was performed using the Pearson correlation test and simple linear regression. Results: In the studied period, we found an association between population coverage and reduced ESF admissions for primary care sensitive conditions in Brazil (β = -28.78, p ≤ 0.01), which occurred in 38.4% of the Federation Units. Conclusion: There was a positive relationship between the expansion of ESF coverage and a decline in hospitalizations for ACSC in the country. The findings of this study help to evaluate the ESF and primary care in Brazil.
“…The process of FHS implantation in Brazil was carried out with difficulties related to the application of financial resources, lack of professionals and lack of commitment from many cities with the primary care proposal 8,13,17 . Financing related to population coverage led to the faster expansion of FHS in smaller cities 17 , but there were difficulties and insufficient coverage in large urban centers 18 . Besides, the heterogeneity of Brazilian States, especially concerning dimension, economic resources, access, availability of professionals and investments, and the political implication, also made it difficult to implement the FHS in Brazil 13 .…”
ABSTRACT:Objective: To evaluate the relationship between hospitalization due to conditions that are sensitive to primary care and the population coverage by the Family Health Strategy (ESF) Units of the Brazilian Federation Units in the last decade. Methods: This is an ecological study that investigated preventable hospitalizations and coverage of primary health care in Brazil in the historic series from 1998 to 2006. Statistical analysis was performed using the Pearson correlation test and simple linear regression. Results: In the studied period, we found an association between population coverage and reduced ESF admissions for primary care sensitive conditions in Brazil (β = -28.78, p ≤ 0.01), which occurred in 38.4% of the Federation Units. Conclusion: There was a positive relationship between the expansion of ESF coverage and a decline in hospitalizations for ACSC in the country. The findings of this study help to evaluate the ESF and primary care in Brazil.
“…Machado et al 5 levantaram a problemática da insuficiente cobertura populacional do ESF nos grandes centros urbanos do país. Os autores consideram que o próprio perfil epidemiológico destas cidades, como por exemplo, a emergência da violência urbana e dos transtornos mentais, direciona a demanda da saúde para fragmentação e especialização do atendimento.…”
Section: Metodologiaunclassified
“…O modelo encontra-se em expansão territorial e tem sido alvo de diversas investigações no intuito de avaliar se a sua implementação tem provocado mudanças efetivas no desempenho do sistema de saúde 3,4,5,6 .…”
Este estudo analisou a correlação entre a evolução da cobertura do Estratégia Saúde da Família (ESF) e a taxa das internações por condições sensíveis à atenção primária (ICSAP), em Campo Grande, Mato Grosso do Sul, Brasil, no período de 2000 a 2009. O estudo de caráter ecológico foi conduzido utilizando-se os dados do Sistema de Informações Hospitalares (SIH), disponíveis no site do Departamento de Informática do SUS (DATASUS) e do Instituto Brasileiro de Geografia e Estatística (IBGE). Na análise estatística foram utilizados o coeficiente de correlação linear de Pearson e sua significância. Campo Grande apresentou correlação inversa seguindo a tendência do país de redução das referidas internações. Na apreciação por categorias de internações observou-se uma correlação direta com a tuberculose pulmonar, a angina pectoris e as doenças relacionadas ao pré-natal e parto. Os resultados sugerem que o aumento da cobertura do ESF tem contribuído para a queda nas taxas de internações por ICSAP.
“…Since then the FHS has been made a priority through the establishment of federal budgetary mechanisms specifically for this model and also through initiatives to extend FHS coverage in medium and large urban centers 4 . However, the transition from the former model, represented by traditional health care facilities, over to the FHS is not yet complete in many cities 3 .…”
Introduction:The Family Health Strategy (FHS) should be first-contact care in the Brazilian Health System. However, Primary Health Care (PHC) still encompasses two models: the FHS and the traditional health care facilities. The expansion of the FHS has been slow and heterogeneous in many cities, rendering a comparative evaluation of key quality-related elements of PHC models crucial. Objective: To compare the performance of PHC models as perceived by health professionals. Methods: A cross-sectional study involving managers and health professionals from PHC of a medium-size city in South-eastern Brazil. Data were collected by applying the Primary Care Assessment Tool. The performance was estimated through primary health care indexes (general and partial PHCI by attributes). Univariate polytomous logistic regression was performed to compare care model performances according to their attributes. Strength of association was estimated by odds ratio with 95% confidence interval. Results: Three managers and 81 health professionals participated in the study. The FHS had a better index rating than the traditional care model for general PHCI and for the attributes longitudinality, comprehensiveness, family focus and professional level. Conclusion: Although the FHS attained higher scores compared to the traditional model, it has not yet achieved the performance expected. This scenario points to the need for increased FHS cover and quality improvements at the existing units.
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