Assessment of the presence and extent of primary care attributes in two coexisting models of the primary health care network of the city of São Paulo

• Autor(a) principal: Brunelli, Bruno
• Data de Publicação: 2016
• Outros Autores: Gusso, Gustavo Diniz Ferreira, Santos, Itamar Souza, Benseñor, Isabela Judith Martins
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://www.rbmfc.org.br/rbmfc/article/view/1241
• topic: Primary Health Care. Health Services Evaluation. Family Health Strategy. Health Services Accessibility.; Atención Primaria de Salud. Evaluación de Servicios de Salud. Estrategia de Salud Familiar. Accesibilidad a los Servicios de Salud; Atenção Primária à Saúde. Avaliação de Serviços de Saúde. Estratégia Saúde da Família. Acesso aos Serviços de Saúde.; Avaliação de Serviços de Saúde

Introduction: In Brazil, there is a lack of information about the direct performance of Primary Health Care. In the city of São Paulo, Outpatient Medical Care units (Assistências Médicas Ambulatoriais - AMAs), walk-in clinics developed to address acute diseases of low complexity, are offered as an alternative to the Family Health Strategy - FHS (Estratégia Saúde da Família), the official Brazilian PHC service, and there are no comparative studies of them. Objectives: To assess the presence and extent of PHC attributes in two units in the city of São Paulo: a Basic Health Unit (Unidade Básica de Saúde - BHU), part of the FHS, and an AMA. Methods: This article is a cross-sectional study using the Primary Care Assessment Tool validated version in Portuguese (PCATool Brazil). Results: Questionnaires were applied to 616 people, 76.3% of whom reported an affiliation with the BHU and 12.3% with the AMA. The BHU users were poorer. The BHU had higher essential and overall scores than the AMA (5.64 and 5.58 versus 3.70 and 3.38, respectively) and higher averages for all the attributes, except for “accessibility” (2.46 compared to 3.68. Only the BHU presented scores over 6.6: “Access to First Contact - Utilization” (7.22) and “Coordination - Systems of Information” (7.31). However, the poor evaluation of the other PCATool attributes in the BHU was preponderant to consider it as a low oriented PHC service, just as the AMA. Conclusion: The users identified a very low level of satisfactory development of PHC attributes in the two services evaluated, even though the BHU scores were higher than those of the AMA in 8 of the 10 attributes. Despite being recognized as a good place to get the first contact to the system, the lack of accessibility affects BHU as a PHC service. The AMA, presented as the solution to the problem, has no performance to justify itself as an alternative.