Theory of change in the evaluation of telehealth in care support to primary health care in brazil / Teoria da mudança na avaliação d0a telehealth no apoio à atenção à saúde primária no brasil

• Autor(a) principal: Nilson, Luana Gabriele
• Data de Publicação: 2020
• Outros Autores: Tuesta, Antonia Angulo-, Hartz, Zulmira Maria de Araújo, Calvo, Maria Cristina Marino
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Health Review
• Texto Completo: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/9447
• topic: Telehealth; Primary Health Care; Program Evaluation.

Background: Telehealth for care support in Public Health is a strategy to strengthen, qualify and increase the resolutivity in health care. However, it still faces challenges for widespread use. Introduction: Brazil is a developing country, whose characteristics of the health system and the working conditions of professionals can be improved with the use of telehealth services provided by a national, public and free program. To understand the processes of use of this program, this article presents a model for evaluation of telehealth for care support in Primary Care in Brazil, guided by the Theory of Change. Materials and Methods: It is a qualitative study, built in four stages: bibliographic analysis; elaboration of the theoretical-logical model; validation by consensus conference among experts; construction of the analysis framework and measures to evaluate the use of services in care support. Results and Discussion: The proposed model resulted in a logical framework with three dimensions: organizational and management scope; knowledge and mastery of technology; human scope and comprehensive health care model. The proposed indicators are guided by the impact of the care support provided by telehealth in Primary Health Care: increase of the quality of care and resolubility; reduction and qualification of referrals to other levels of care; expansion of access with reduced waiting time for services; reduction of costs and optimization of the use of resources within the health system; organization and strengthening of networking; satisfaction and professional fixation in locations far from major centers. Conclusions: A proposed evaluation of telehealth, which aims to understand processes and stimulate change, is useful and necessary to ensure the achievement of the results of the program in the qualification of health care. Keywords: Telehealth; Primary Health Care; Program Evaluation.