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

Abstract

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.

Atuação cotidiana no Sistema Único de Saúde em sua terceira década

“…FHS represents the main strategy to qualify the care provided in PHC, ensuring the principles of SUS, being a strategy capable of structuring and ordering the RAS for full and equitable access, according to people's needs. 2,24 Through RAS, seeks to provide services effectively and with horizontal relationships, and it is essential to ensure universal access to health actions and services, according to the need. 25 However, even with the advances achieved in PHC after the implantation and expansion of the FHS, it is recognized that its principles and praxis still do not reflect the reality in the daily routine of services, especially in relation to comprehensive care; there are great challenges with regard to the profile of professionals and teamwork, with a view to resolving health demands.…”

“…Thus, it creates the Family Health Strategy (FHS), with a view to implementing universal, comprehensive and equitable care to the population, without restrictions, reaffirming the accessibility of Brazilian citizens to health actions. [1][2][3] However, after three decades of creation of SUS, PHC still cannot meet health demands of users in a timely and necessary manner, with major obstacles to consolidating SUS principles. "Guarantee and expansion of access and effectiveness of care in the SUS depend on the availability of resources, and it is crucial to seek the improvement of funding".…”

Atenção ao pré-natal de gestantes de risco e fatores associados no Município de São Paulo, Brasil

“…Conforme já apontado pela literatura, há uma associação entre a implantação da ESF e a melhoria da qualidade do pré-natal 11,31,32 . Quando comparada aos serviços do tipo UBS tradicional, a ESF destaca-se por apresentar uma organização que favorece a identificação das necessidades de saúde da população e maior integração com as famílias e comunidade, ampliando o vínculo do serviço com a população.…”

“…Quando comparada aos serviços do tipo UBS tradicional, a ESF destaca-se por apresentar uma organização que favorece a identificação das necessidades de saúde da população e maior integração com as famílias e comunidade, ampliando o vínculo do serviço com a população. Exemplificam essa organização as práticas como a delimitação de área de abrangência, restrição do tamanho da população coberta, abordagem por equipe multiprofissional, visitas domiciliares e atuação dos ACS 32 .…”

Programa Mais Médicos Em Município De Fronteira Internacional E Os Desafios Da Gestão Em Saúde

“…Nesta pesquisa, o encerramento da amostra ocorreu pelo princípio da saturação teórico-discursiva. Tal princípio é definido como a suspensão de inclusão de novos participantes quando os dados obtidos passam a apresentar redundância e repetição (Fontanella et al, 2011).…”