Mapeando os atos e ações de saúde ofertadas nas unidades da estratégia saúde da família e as internações por condições sensíveis à atenção primária: ancorando a construção de um indicador sintético em municípios brasileiros

• Autor(a) principal: Pereira, Francilene Jane Rodrigues
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/tede/7963
• topic: Prevenção primária; Primary prevention; Atenção primária à saúde; Políticas públicas em saúde; Primary health care; Quality indicators; Health care; CIENCIAS DA SAUDE::SAUDE COLETIVA

Hospitalization for Primary Care Sensitive Conditions is a set of pathology groups attended in tertiary health services that should have been, a priori, remedied and/or controlled by effective health actions in the primary care. Thus, this research is justified by the need to experience these hospitalizations as an indicator of access and quality of the Brazilian primary care. For this, the objective is to build a Synthetic Statistical Indicator able to provide data on dialogicity between Hospitalization for Primary Care Sensitive Conditions and health actions offered in the Strategy Units of the Family Health throughout the national territory, besides understanding the temporal evolution of the occurrence of Hospitalization for Primary Care Sensitive Conditions in Brazil and in cities with extreme scores in the indicator from the socio-political and economic implications that interfere in health care offered at the primary level of health care. The thesis defended is that the existence of a synthetic statistical indicator able to support decision making in the Family Health Units will assist the reference and counter reference system, providing safety and quickness to it. It is an ecological study of quantitative and qualitative approaches conducted from the secondary database of Hospital Information System with a selection of the absolute frequencies of the main Diagnosis for hospitalization of diseases sensitive to primary care per Brazilian city with over 100,000 inhabitants from 2009 to 2014, followed by groups of pathologies transformed into rates per 10,000 inhabitants and processed by the Principal Component Analysis technique with the help of TabNet Win 32 2.7 tools, Excel for Windows and software R 3.0.3. Qualitative analysis was funded by situationality analysis. The results showed a trend to reducing Hospitalization for Primary Care Sensitive Conditions in recent years, especially the ones standing out with the higher percentages, which are pneumonia, cerebrovascular disease and heart failure. Among Brazilian regions, despite presenting approximate values in rates, the North and the Southeast stood out for the highest and lowest incidence of these hospitalizations, respectively. The Main Component Analysis method was used from the data covariance matrix to support the construction of a Synthetic Statistical Indicator and the ranking of cities. In 2014, Nilópolis in the state of Rio de Janeiro and Altamira in the state of Pará occupied the best and worst position among the cities studied. It was also noticed that the majority of the fifteen worst cities were located in the North and Northeast. In the score in classes according to the indicator, a low percentage of cities in intermediate and poor classes was registered. Although progress is perceived in the context of primary health care in Brazil, the prospect of total reduction of ICSAP to minimum, as it is desirable, is still at the level of utopias. The use of this synthetic indicator will be a powerful tool to service managers in order to subsidize proposals for health actions in the territories under their responsibility in situations requiring greater attention in this field.