Quality and effectiveness of different approaches to primary care delivery in Brazil

Harzheim, Erno; Duncan, Bruce Bartholow; Stein, Airton Tetelbom; Cunha, Carlo Roberto Hackmann da; Gonçalves, Marcelo Rodrigues; Trindade, Thiago Gomes da; Oliveira, Mônica Maria Celestina de; Pinto, Maria Eugênia Bresolin

doi:10.1186/1472-6963-6-156

Cited by 55 publications

(54 citation statements)

References 23 publications

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“…However, the Basic Traditional Unit (UBS) scores do not reach Primary Care (APS) standards for the care of children. Studies from other regions nationwide corroborate the finding in traditional units, identifying difficulties experienced with respect to meeting the objectives of APS (11)(12)(13)(14) . The only scores that identified as suitable for APS in ESF units were found in Curitiba (14) .…”

Section: Discussionsupporting

confidence: 61%

Children's health care assistance according to their families: a comparison between models of Primary Care

Oliveira

Veríssimo

2015

Rev. esc. enferm. USP

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Objective:To compare the health assistance models of Basic Traditional Units (UBS) with the Family Health Strategy (ESF) units for presence and extent of attributes of Primary Health Care (APS), specifically in the care of children. Method: A crosssectional study of a quantitative approach with families of children attended by the Public Health Service of Colombo, Paraná. The Primary Care Assessment Tool (PCA-Tool) was applied to parents of 482 children, 235 ESF units and 247 UBS units covering all primary care units of the municipality, between June and July 2012. The results were analyzed according to the PCA-Tool manual. Results: ESF units reached a borderline overall score for primary health care standards. However, they fared better in their attributes of Affiliation, Integration of care coordination, Comprehensiveness, Family Centeredness and Accessibility of use, while the attributes of Community Guidance/Orientation, Coordination of Information Systems, Longitudinality and Access attributes were rated as insufficient for APS. UBS units had low scores on all attributes. Conclusion: The ESF units are closer to the principles of APS (Primary Health Care), but there is need to review actions of child care aimed at the attributes of APS in both care models, corroborating similar studies from other regions of Brazil. DESCRIPTORS INTRODUCTIONAfter more than thirty years since the Alma Ata Conference, Primary Health Care (APS) has consolidated as one of the most equitable and efficient ways to organize a health system (1) by advocating equitable care with quality to the population, among other benefits. The Pan American Health Organization (PAHO) defines Primary Health Care as a "strategy for organizing health care systems in order to enable universal access to services and comprehensive and integrated care over time" (1)(2) .At the national level, the Ministry of Health adopted the Family Health Strategy (ESF) in 1994 to reorganize the Unified Health System (SUS) and expand the APS. According to the Ministry of Health in Brazil (3) , the number of family health teams deployed and funding for the expansion of the ESF have both increased, reaching/covering 52.1% of the Brazilian population.The scientific literature provides evidence of the association between greater APS orientation and increasing the effectiveness of health systems, promotion of fairness, user satisfaction and efficiency (4) . It is noteworthy that most of the studies are centered on the health systems of developed countries (4) . However, there is evidence of the positive impact of APS on the health systems of developing countries, primarily those which are located in Latin America.On the international scene, it has been observed (5-6) that increasing ESF coverage is linked to reducing infant mortality and promoting greater equity. Such evidence is present in the national results (7)(8) , studies which also indicate a higher quality of prenatal care, child care, offering use of health services, although in a low effectiveness context ...

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Section: Discussionsupporting

confidence: 61%

Children's health care assistance according to their families: a comparison between models of Primary Care

Oliveira

Veríssimo

2015

Rev. esc. enferm. USP

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“…Esse instrumento é baseado em diversos itens e tem como objetivo medir a presença e a extensão dos seguintes atributos: acesso ao primeiro contato, longitudinalidade, coordenação, integralidade, orientação familiar e orientação comunitária. As duas versões do PCATool (saúde da criança e do adulto) para aplicação aos usuários dos serviços de saúde já foram traduzidas e validadas no Brasil 13,14 . O instrumento destinado aos profissionais de saúde utilizado neste estudo é a versão em espelho da versão validada para usuários adultos.…”

Section: Descrição Do Pcatoolunclassified

Avaliação da presença e extensão dos atributos da atenção primária em Curitiba

Chomatas

Vigo

Marty

et al. 2013

Rev Bras Med Fam Comunidade

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“…Este estudo é parte do projeto "Avaliação da qualidade do processo de atenção e da sua efetividade sobre a saúde do adulto no Programa Saúde da Família e em modelos alternativos na rede de atenção primária do município de Porto Alegre" 24 , com amostra total calculada em 3000 pessoas, por meio do pacote estatístico EPI-INFO 6.0, utilizando dados provenientes do estudo de validação da versão infantil do PCATool 25 e da literatura nacional sobre prevalência, reconhecimento e controle do DM 13 . O processo de amostragem dos domicílios foi por conglomerado (clusters), sendo estratificada por gerência distrital de saúde do município e distribuída proporcionalmente ao tamanho das populações adscritas a cada unidade de saúde dos serviços de APS.…”

Section: Delineamento Do Estudo E Amostragemunclassified