Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines

Detalhes bibliográficos
Autor(a) principal: Rose Lodeiro Castanheira, Elen
Data de Publicação: 2024
Outros Autores: Schiavon Duarte, Lígia, Martins de Oliveira Viana, Mônica, Olívia Nunes, Luceime, Fernanda Tortorelli Zarili, Thais, Siqueira Mendonça, Carolina, Rodrigues Sanine, Patricia
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519
Resumo: This study analyzes the main organization patterns used by primary health care (PHC) services in municipal networks and evaluates them according to indicators of local management-administration interface. Evaluative research analyzed 461 municipalities in São Paulo, Brazil, that participated in the Primary Care Services Quality Assessment Survey (QualiAB) in 2017/2018, classified according to the organizational arrangements composition of 2,472 PHC services. Eight indicators of local management and administration were selected to evaluate the identified patterns. Results indicate two groups of municipalities: homogeneous, with services presenting the same arrangement (43.6%); and heterogeneous, with different arrangements (56.4%). These were subdivided into seven patterns that ranged from homogeneous-traditional, homogeneous-Family Health Strategy, homogeneous-mixed, and different combinations in the heterogeneous group. All indicators showed significant differences between groups (p < 0.001), especially the homogeneous-traditional group, which presented an organizational pattern far from the desired model of a comprehensive and problem-solving PHC. Those integrated with family health units (FHU) and basic health units with community health workers and/or family health teams (BHU/FHU) showed a pattern closer to a comprehensive model – with planning and evaluation actions committed to the local reality and qualification of care. Implementation of federal and state policies are essential for defining the PHC health care model adopted by municipalities.
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spelling Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelinesOrganización de la atención primaria de salud de municipios de São Paulo, Brasil: modelo de atención y coherencia con las directrices del Sistema Único de SaludOrganização da atenção primária à saúde de municípios de São Paulo, Brasil: modelo de atenção e coerência com as diretrizes do Sistema Único de SaúdeAtenção Primária à Saúde; Modelos de Assistência à Saúde; Avaliação de Serviços de Saúde; Organização e AdministraçãoAtención Primaria de Salud; Modelos de Atención de Salud; Evaluación de Servicios de Salud; Organización y AdministraciónPrimary Health Care; Healthcare Models; Health Services Evaluation; Organization and AdministrationThis study analyzes the main organization patterns used by primary health care (PHC) services in municipal networks and evaluates them according to indicators of local management-administration interface. Evaluative research analyzed 461 municipalities in São Paulo, Brazil, that participated in the Primary Care Services Quality Assessment Survey (QualiAB) in 2017/2018, classified according to the organizational arrangements composition of 2,472 PHC services. Eight indicators of local management and administration were selected to evaluate the identified patterns. Results indicate two groups of municipalities: homogeneous, with services presenting the same arrangement (43.6%); and heterogeneous, with different arrangements (56.4%). These were subdivided into seven patterns that ranged from homogeneous-traditional, homogeneous-Family Health Strategy, homogeneous-mixed, and different combinations in the heterogeneous group. All indicators showed significant differences between groups (p < 0.001), especially the homogeneous-traditional group, which presented an organizational pattern far from the desired model of a comprehensive and problem-solving PHC. Those integrated with family health units (FHU) and basic health units with community health workers and/or family health teams (BHU/FHU) showed a pattern closer to a comprehensive model – with planning and evaluation actions committed to the local reality and qualification of care. Implementation of federal and state policies are essential for defining the PHC health care model adopted by municipalities.El trabajo tiene el objetivo de analizar los principales patrones de organización de las redes municipales de servicios de atención primaria de salud (APS) y evaluarlos conforme los indicadores de interfaz entre la dirección y gestión local. Se trata de una investigación evaluativa que analizó 461 municipios de São Paulo, Brasil, que participaron de la Encuesta de Evaluación de la Calidad de los Servicios de Atención Primaria (QualiAB) en 2017/2018, clasificados según la composición de los arreglos organizativos de 2.472 servicios de APS. Para evaluar los patrones identificados, se seleccionaron ocho indicadores de dirección y gestión local. Los resultados indican dos grupos de municipios: homogéneos, con servicios de un mismo arreglo (43,6%) e heterogéneos, con arreglos diferentes (56,4%). Los grupos se subdividieron en siete patrones que iban desde homogéneo-tradicional, homogéneo-Estrategia de Salud de la Familia, homogéneo-mixto y diferentes combinaciones en el grupo heterogéneo. Todos los indicadores señalaron diferencias significativas entre los grupos (p < 0,001), con destaque para el grupo homogéneo-tradicional, con patrón organizativo alejado del modelo deseado para una APS completa y resolutiva, mientras aquellos con unidades de salud de la familia (USF), y con unidades básicas con agentes comunitarios de salud y/o equipos de salud de la familia (UBS/USF) demostraron un patrón más cercano a este modelo -con acciones de planificación y evaluación comprometidas con la realidad local y con la calificación del trabajo. Se discute la importancia de las políticas implementadas por la gestión federal y la gestión estatal y su poder de inducción para definir el modelo de atención a la salud en la APS de los municipios.Este trabalho tem como objetivo analisar os principais padrões de organização das redes municipais de serviços de atenção primária à saúde (APS) e avaliá-los segundo os indicadores de interface entre gestão e gerenciamento local. Trata-se de pesquisa avaliativa que analisou 461 municípios de São Paulo, Brasil, que participaram do Inquérito de Avaliação da Qualidade de Serviços de Atenção Básica (QualiAB) em 2017/2018, classificados segundo a composição dos arranjos organizacionais de 2.472 serviços de APS. Para avaliar os padrões identificados, foram selecionados oito indicadores de gestão e gerenciamento local. Os resultados apontam dois grupos de municípios: homogêneos, com serviços de um mesmo arranjo (43,6%); e heterogêneos, com diferentes arranjos (56,4%). Os grupos foram subdivididos em sete padrões que variaram entre homogêneo-tradicional, homogêneo-Estratégia Saúde da Família, homogêneo-misto e diferentes combinações no grupo heterogêneo. Todos os indicadores apontaram diferenças significativas entre os grupos (p < 0,001), com destaque para o grupo homogêneo-tradicional, com padrão organizacional distante do modelo desejado para uma APS abrangente e resolutiva, enquanto aqueles com unidades de saúde da família (USF), e com unidades básicas com agentes comunitários de saúde e/ou equipes de saúde da família (UBS/USF) demonstraram um padrão mais aproximado desse modelo – com ações de planejamento e avaliação comprometidos com a realidade local e com a qualificação do trabalho. Discute-se a importância das políticas implementadas pela gestão federal e estadual e seu poder de indução na definição do modelo de atenção à saúde na APS dos municípios.Reports in Public HealthCadernos de Saúde Pública2024-02-23info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdftext/xmlhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519Reports in Public Health; Vol. 40 No. 2 (2024): FebruaryCadernos de Saúde Pública; v. 40 n. 2 (2024): Fevereiro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZporenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519/18995https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519/18996https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519/18997Copyright (c) 2024 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessRose Lodeiro Castanheira, ElenSchiavon Duarte, LígiaMartins de Oliveira Viana, MônicaOlívia Nunes, LuceimeFernanda Tortorelli Zarili, ThaisSiqueira Mendonça, CarolinaRodrigues Sanine, Patricia2024-02-23T13:31:39Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8519Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:42.342484Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
Organización de la atención primaria de salud de municipios de São Paulo, Brasil: modelo de atención y coherencia con las directrices del Sistema Único de Salud
Organização da atenção primária à saúde de municípios de São Paulo, Brasil: modelo de atenção e coerência com as diretrizes do Sistema Único de Saúde
title Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
spellingShingle Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
Rose Lodeiro Castanheira, Elen
Atenção Primária à Saúde; Modelos de Assistência à Saúde; Avaliação de Serviços de Saúde; Organização e Administração
Atención Primaria de Salud; Modelos de Atención de Salud; Evaluación de Servicios de Salud; Organización y Administración
Primary Health Care; Healthcare Models; Health Services Evaluation; Organization and Administration
title_short Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
title_full Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
title_fullStr Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
title_full_unstemmed Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
title_sort Primary health care organization in municipalities of São Paulo, Brazil: a model of care aligned with the Brazilian Unified National Health System’s guidelines
author Rose Lodeiro Castanheira, Elen
author_facet Rose Lodeiro Castanheira, Elen
Schiavon Duarte, Lígia
Martins de Oliveira Viana, Mônica
Olívia Nunes, Luceime
Fernanda Tortorelli Zarili, Thais
Siqueira Mendonça, Carolina
Rodrigues Sanine, Patricia
author_role author
author2 Schiavon Duarte, Lígia
Martins de Oliveira Viana, Mônica
Olívia Nunes, Luceime
Fernanda Tortorelli Zarili, Thais
Siqueira Mendonça, Carolina
Rodrigues Sanine, Patricia
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Rose Lodeiro Castanheira, Elen
Schiavon Duarte, Lígia
Martins de Oliveira Viana, Mônica
Olívia Nunes, Luceime
Fernanda Tortorelli Zarili, Thais
Siqueira Mendonça, Carolina
Rodrigues Sanine, Patricia
dc.subject.por.fl_str_mv Atenção Primária à Saúde; Modelos de Assistência à Saúde; Avaliação de Serviços de Saúde; Organização e Administração
Atención Primaria de Salud; Modelos de Atención de Salud; Evaluación de Servicios de Salud; Organización y Administración
Primary Health Care; Healthcare Models; Health Services Evaluation; Organization and Administration
topic Atenção Primária à Saúde; Modelos de Assistência à Saúde; Avaliação de Serviços de Saúde; Organização e Administração
Atención Primaria de Salud; Modelos de Atención de Salud; Evaluación de Servicios de Salud; Organización y Administración
Primary Health Care; Healthcare Models; Health Services Evaluation; Organization and Administration
description This study analyzes the main organization patterns used by primary health care (PHC) services in municipal networks and evaluates them according to indicators of local management-administration interface. Evaluative research analyzed 461 municipalities in São Paulo, Brazil, that participated in the Primary Care Services Quality Assessment Survey (QualiAB) in 2017/2018, classified according to the organizational arrangements composition of 2,472 PHC services. Eight indicators of local management and administration were selected to evaluate the identified patterns. Results indicate two groups of municipalities: homogeneous, with services presenting the same arrangement (43.6%); and heterogeneous, with different arrangements (56.4%). These were subdivided into seven patterns that ranged from homogeneous-traditional, homogeneous-Family Health Strategy, homogeneous-mixed, and different combinations in the heterogeneous group. All indicators showed significant differences between groups (p < 0.001), especially the homogeneous-traditional group, which presented an organizational pattern far from the desired model of a comprehensive and problem-solving PHC. Those integrated with family health units (FHU) and basic health units with community health workers and/or family health teams (BHU/FHU) showed a pattern closer to a comprehensive model – with planning and evaluation actions committed to the local reality and qualification of care. Implementation of federal and state policies are essential for defining the PHC health care model adopted by municipalities.
publishDate 2024
dc.date.none.fl_str_mv 2024-02-23
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519
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dc.language.iso.fl_str_mv por
eng
language por
eng
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519/18995
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519/18996
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8519/18997
dc.rights.driver.fl_str_mv Copyright (c) 2024 Cadernos de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2024 Cadernos de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
text/xml
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 40 No. 2 (2024): February
Cadernos de Saúde Pública; v. 40 n. 2 (2024): Fevereiro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
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instacron:FIOCRUZ
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reponame_str Cadernos de Saúde Pública
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repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
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