Availability of essential medicines in primary health care of the Brazilian Unified Health System
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/139736 |
Resumo: | OBJECTIVE: To characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS). METHODS: This is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename – National List of Essential Medicines) of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals). The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed. RESULTS: One thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis. CONCLUSIONS: The low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain management. The different views on the availability of tracer medicines in SUS confirm the general availability verified in this study. Among patients, about 60% said they obtain medicines in SUS units, data consistent with the lack of medicines reported by medicine dispensers and in line with physicians’ evaluations |
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Availability of essential medicines in primary health care of the Brazilian Unified Health SystemDisponibilidade de medicamentos essenciais na atenção primária do Sistema Único de SaúdeMedicamentos Essenciaisprovisão & distribuição. Assistência Farmacêutica. Atenção Primária à Saúde. Pesquisa sobre Serviços de Saúde. Sistema Único de SaúdeDrugsEssentialsupply & distribution. Pharmaceutical Services. Primary Health Care. Health Services Research. Unified Health SystemOBJECTIVE: To characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS). METHODS: This is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename – National List of Essential Medicines) of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals). The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed. RESULTS: One thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis. CONCLUSIONS: The low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain management. The different views on the availability of tracer medicines in SUS confirm the general availability verified in this study. Among patients, about 60% said they obtain medicines in SUS units, data consistent with the lack of medicines reported by medicine dispensers and in line with physicians’ evaluationsOBJETIVO: Caracterizar a disponibilidade física de medicamentos traçadores nos serviços de assistência farmacêutica na atenção primária do Sistema Único de Saúde. MÉTODOS: Estudo transversal de natureza avaliativa, integrante da Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015. Para a análise da disponibilidade física, foram verificados 50 itens selecionados da Relação Nacional de Medicamentos Essenciais 2012. Roteiros de observação foram aplicados nos serviços de dispensação de medicamentos na atenção primária. Foram realizadas entrevistas com usuários, profissionais de saúde e gestores municipais, por meio de questionários semiestruturados. O índice de disponibilidade foi apresentado como o percentual de unidades de saúde onde os medicamentos estavam disponíveis. Para a análise estatística foram apresentadas frequências absolutas, relativas e médias (com intervalos de 95% de confiança). A comparação de grupos foi realizada por meio dos testes Qui-quadrado de Pearson ou análise de variância, quando adequados. RESULTADOS: Foram preenchidos 1.175 roteiros de observação em amostra nacional representativa composta por 273 municípios. Observaram-se diferenças estatisticamente significantes em relação ao tipo de unidade, infraestrutura e presença do profissional farmacêutico entre as regiões do Brasil. A disponibilidade média dos medicamentos traçadores na atenção primária foi de 52,9%, com diferenças entre regiões e estratos amostrais. Quando analisados todos os medicamentos, exceto os fitoterápicos, o índice elevou para 62,5%. Verificou-se disponibilidade inadequada de medicamentos para o tratamento de doenças crônicas e para doenças epidemiologicamente importantes, como a tuberculose e a sífilis congênita. CONCLUSÕES: A baixa disponibilidade de medicamentos de aquisição centralizada indica possíveis deficiências na gestão da cadeia logística. As diferentes percepções sobre a disponibilidade dos medicamentos traçadores no SUS corroboram com os índices de disponibilidade geral verificados pelo estudo. Dentre os usuários, aproximadamente 60% afirmaram obter os medicamentos que necessitaram nas unidades do SUS, informação coerente com a falta de medicamentos relatada pelos responsáveis pela dispensação de medicamentos e com a avaliação dos médicosUniversidade de São Paulo. Faculdade de Saúde Pública2017-09-22info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfapplication/xmlhttps://www.revistas.usp.br/rsp/article/view/13973610.11606/S1518-8787.2017051007062Revista de Saúde Pública; Vol. 51 (2017): Suplemento 2; 10sRevista de Saúde Pública; Vol. 51 (2017): Suplemento 2; 10sRevista de Saúde Pública; v. 51 (2017): Suplemento 2; 10s1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPengporhttps://www.revistas.usp.br/rsp/article/view/139736/135003https://www.revistas.usp.br/rsp/article/view/139736/135004https://www.revistas.usp.br/rsp/article/view/139736/148254Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessNascimento, Renata Cristina Rezende Macedo doÁlvares, JulianaGuerra Junior, Augusto AfonsoGomes, Isabel CristinaCosta, Ediná AlvesLeite, Silvana NairCosta, Karen SarmentoSoeiro, Orlando MarioGuibu, Ione AquemiKarnikowski, Margô Gomes de OliveiraAcurcio, Francisco de Assis2017-10-23T19:07:50Zoai:revistas.usp.br:article/139736Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2017-10-23T19:07:50Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Availability of essential medicines in primary health care of the Brazilian Unified Health System Disponibilidade de medicamentos essenciais na atenção primária do Sistema Único de Saúde |
title |
Availability of essential medicines in primary health care of the Brazilian Unified Health System |
spellingShingle |
Availability of essential medicines in primary health care of the Brazilian Unified Health System Nascimento, Renata Cristina Rezende Macedo do Medicamentos Essenciais provisão & distribuição. Assistência Farmacêutica. Atenção Primária à Saúde. Pesquisa sobre Serviços de Saúde. Sistema Único de Saúde Drugs Essential supply & distribution. Pharmaceutical Services. Primary Health Care. Health Services Research. Unified Health System |
title_short |
Availability of essential medicines in primary health care of the Brazilian Unified Health System |
title_full |
Availability of essential medicines in primary health care of the Brazilian Unified Health System |
title_fullStr |
Availability of essential medicines in primary health care of the Brazilian Unified Health System |
title_full_unstemmed |
Availability of essential medicines in primary health care of the Brazilian Unified Health System |
title_sort |
Availability of essential medicines in primary health care of the Brazilian Unified Health System |
author |
Nascimento, Renata Cristina Rezende Macedo do |
author_facet |
Nascimento, Renata Cristina Rezende Macedo do Álvares, Juliana Guerra Junior, Augusto Afonso Gomes, Isabel Cristina Costa, Ediná Alves Leite, Silvana Nair Costa, Karen Sarmento Soeiro, Orlando Mario Guibu, Ione Aquemi Karnikowski, Margô Gomes de Oliveira Acurcio, Francisco de Assis |
author_role |
author |
author2 |
Álvares, Juliana Guerra Junior, Augusto Afonso Gomes, Isabel Cristina Costa, Ediná Alves Leite, Silvana Nair Costa, Karen Sarmento Soeiro, Orlando Mario Guibu, Ione Aquemi Karnikowski, Margô Gomes de Oliveira Acurcio, Francisco de Assis |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Nascimento, Renata Cristina Rezende Macedo do Álvares, Juliana Guerra Junior, Augusto Afonso Gomes, Isabel Cristina Costa, Ediná Alves Leite, Silvana Nair Costa, Karen Sarmento Soeiro, Orlando Mario Guibu, Ione Aquemi Karnikowski, Margô Gomes de Oliveira Acurcio, Francisco de Assis |
dc.subject.por.fl_str_mv |
Medicamentos Essenciais provisão & distribuição. Assistência Farmacêutica. Atenção Primária à Saúde. Pesquisa sobre Serviços de Saúde. Sistema Único de Saúde Drugs Essential supply & distribution. Pharmaceutical Services. Primary Health Care. Health Services Research. Unified Health System |
topic |
Medicamentos Essenciais provisão & distribuição. Assistência Farmacêutica. Atenção Primária à Saúde. Pesquisa sobre Serviços de Saúde. Sistema Único de Saúde Drugs Essential supply & distribution. Pharmaceutical Services. Primary Health Care. Health Services Research. Unified Health System |
description |
OBJECTIVE: To characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS). METHODS: This is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename – National List of Essential Medicines) of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals). The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed. RESULTS: One thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis. CONCLUSIONS: The low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain management. The different views on the availability of tracer medicines in SUS confirm the general availability verified in this study. Among patients, about 60% said they obtain medicines in SUS units, data consistent with the lack of medicines reported by medicine dispensers and in line with physicians’ evaluations |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-09-22 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/139736 10.11606/S1518-8787.2017051007062 |
url |
https://www.revistas.usp.br/rsp/article/view/139736 |
identifier_str_mv |
10.11606/S1518-8787.2017051007062 |
dc.language.iso.fl_str_mv |
eng por |
language |
eng por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/139736/135003 https://www.revistas.usp.br/rsp/article/view/139736/135004 https://www.revistas.usp.br/rsp/article/view/139736/148254 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf application/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 51 (2017): Suplemento 2; 10s Revista de Saúde Pública; Vol. 51 (2017): Suplemento 2; 10s Revista de Saúde Pública; v. 51 (2017): Suplemento 2; 10s 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
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1787713238210707456 |