Organization and delivery of primary health care services in Petrópolis, Brazil

Abstract

The objective of the study was to adapt and apply an instrument to measure the organizational features of the primary care system in the municipality of Petrópolis. The study compared the performance of the new Family Health Program (Programa Saúde da Família or PSF) with traditional primary care facilities using data from facility surveys and key informant interviews. The main results include: (a) the methodology was capable of distinguishing between the two types of primary care services in the municipality; (b) the PSF clinics scored higher on most dimensions of primary care, although in some areas the traditional health units had equivalent scores; and (c) data obtained from interviewing key informants was generally compatible with that obtained by conducting facility surveys. The results suggests that in spite of making important advances in primary care, the municipality of Petrópolis continues to face several challenges including the need to improve access, enforce the gatekeeper role of primary care, and improve the coordination and community orientation of both types of primary care services. The methodology could be used to set objectives and monitor progress towards improving the organization and delivery of primary care in Petrópolis and elsewhere.

Assessment of access to primary health care among children and adolescents hospitalized due to avoidable conditions

“…Although both the patients under the non-FHS model and the FHS model evaluated this attribute poorly, the score was significantly better in the latter ( Table 1). The comparison between the FHS and the traditional model of the BHU in terms of access has already been described by other authors, with most finding little difference between the two models, 25,35,36 while others describe problems relating to the organization of the services and conclude that the FHS has not worked as a good gateway. 26,37 In the present study, 74% of users of the FHS gave a score of less than 6.6 to First Contact Access, but this assessment was significantly better than that made by patients in the traditional model ( Table 1).…”

Comprehensive Primary Health Care in South America: contexts, achievements and policy implications

“…Other factors related to comprehensiveness included the professional development and cultural competency of health staff 56 . Primary health care strategies aimed at improving comprehensiveness of services were most effective when the following factors were present: multidisciplinary teams rendered various types of care at the point of service; differing conceptions of health and illness were successfully promoted; coordinated care through all stages of life was provided 57,58 . For example, the Makewe-Palale Hospital in Chile, a primary health care level site administered by a local Mapuche indigenous association, developed the Intercultural Health Care Model that supports the use of Western medicine to complement the indigenous medical systems already in place.…”

“…When the focus of care worker training is changed from the hospital and private health care market to the individual and community services, programs become more consistent with the goals of primary health care 6,15,35,39,57 .…”

“…• It is necessary to develop evaluation methods that assess primary health care not only as a provider of basic health services, but also as a stimulant of overall human development and provide orientation and guidance for health system planning and implementation at local and national level 56,57,71,72 .…”

Repensando acesso, qualificando o cuidado: relato do trabalho em duas equipes de saúde da família

“…4 Há poucos estudos abordando tempo de espera ou outras facetas do acesso na ESF. De fato, quando avaliado por usuários e profissionais de diferentes regiões brasileiras, é considerado uma fragilidade dos serviços, como em São Luís (MA), 6 Petrópolis (RJ), 7 Curitiba (PR), 8 Porto Alegre (RS), 9 Goiás e Mato A metodologia utilizada foi brainstorming, 20 seguida de enumeração por consenso das seguintes demandas que, segundo os profissionais, contribuem para a lotação das agendas: a) solicitação de atestados para atividade física; b) solicitação de liberação para retornar à creche/escola após período de afastamento por atestado médico; c) retorno de pacientes com doenças crônicas não degenerativas para mostrar exames laboratoriais normais. Outro ponto levantado foi a necessidade de maior agilidade para atendimento às gestantes e puérperas.…”