Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series

Detalhes bibliográficos
Autor(a) principal: Pires,Débora Castanheira
Data de Publicação: 2021
Outros Autores: Campos,Mônica Rodrigues, Emmerrick,Isabel Martins
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista de Saúde Pública
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102021000100214
Resumo: ABSTRACT OBJECTIVE: To analyze the impact of implementing the Contrato Organizativo de Ação Pública (COAP – Public Action Organizational Contract) on the expansion of access to primary care in the states of Ceará and Mato Grosso do Sul. METHODS: We used the interrupted time series method to analyze the effect of COAP on primary care coverage (PCCov) and on avoidable hospitalization rates. To analyze the effects of increased PCCov on avoidable hospitalizations, we used non-segmented time series models. RESULTS: The results showed that implementing COAP had a positive impact on increased coverage in both cases, with did not happen in the control states. However, this impact was not reflected in the decrease in hospitalizations due to primary care sensitive conditions (HPCSC) or for acute preventable causes. When we analyzed the effects of the increase in PCCov on avoidable hospitalizations between 2009 and 2016, we observed that coverage had a positive impact on the decrease in the rate of HPCSC only in Ceará, although hospitalizations have a significant trend to decrease in time both in this state and in Mato Grosso do Sul, except for acute respiratory infections. CONCLUSIONS: The COAP continues to be the regulatory instrument of regionalization force, however, the results obtained by adhering to it in the expansion of primary care in Ceará and Mato Grosso do Sul makes us question whether the contractual model, as predicted, is the best instrument for advancing regionalization in the Brazilian Unified Health System.
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spelling Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time seriesUnified Health SystemRegional Health PlanningPrimary Health CareEvaluation Studies as TopicProgram EvaluationABSTRACT OBJECTIVE: To analyze the impact of implementing the Contrato Organizativo de Ação Pública (COAP – Public Action Organizational Contract) on the expansion of access to primary care in the states of Ceará and Mato Grosso do Sul. METHODS: We used the interrupted time series method to analyze the effect of COAP on primary care coverage (PCCov) and on avoidable hospitalization rates. To analyze the effects of increased PCCov on avoidable hospitalizations, we used non-segmented time series models. RESULTS: The results showed that implementing COAP had a positive impact on increased coverage in both cases, with did not happen in the control states. However, this impact was not reflected in the decrease in hospitalizations due to primary care sensitive conditions (HPCSC) or for acute preventable causes. When we analyzed the effects of the increase in PCCov on avoidable hospitalizations between 2009 and 2016, we observed that coverage had a positive impact on the decrease in the rate of HPCSC only in Ceará, although hospitalizations have a significant trend to decrease in time both in this state and in Mato Grosso do Sul, except for acute respiratory infections. CONCLUSIONS: The COAP continues to be the regulatory instrument of regionalization force, however, the results obtained by adhering to it in the expansion of primary care in Ceará and Mato Grosso do Sul makes us question whether the contractual model, as predicted, is the best instrument for advancing regionalization in the Brazilian Unified Health System.Faculdade de Saúde Pública da Universidade de São Paulo2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102021000100214Revista de Saúde Pública v.55 2021reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USP10.11606/s1518-8787.2021055003001info:eu-repo/semantics/openAccessPires,Débora CastanheiraCampos,Mônica RodriguesEmmerrick,Isabel Martinseng2021-05-06T00:00:00Zoai:scielo:S0034-89102021000100214Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0034-8910&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.phprevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2021-05-06T00:00Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
title Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
spellingShingle Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
Pires,Débora Castanheira
Unified Health System
Regional Health Planning
Primary Health Care
Evaluation Studies as Topic
Program Evaluation
title_short Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
title_full Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
title_fullStr Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
title_full_unstemmed Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
title_sort Impact of COAP on access to primary care in Ceará and Mato Grosso do Sul through the analysis of interrupted time series
author Pires,Débora Castanheira
author_facet Pires,Débora Castanheira
Campos,Mônica Rodrigues
Emmerrick,Isabel Martins
author_role author
author2 Campos,Mônica Rodrigues
Emmerrick,Isabel Martins
author2_role author
author
dc.contributor.author.fl_str_mv Pires,Débora Castanheira
Campos,Mônica Rodrigues
Emmerrick,Isabel Martins
dc.subject.por.fl_str_mv Unified Health System
Regional Health Planning
Primary Health Care
Evaluation Studies as Topic
Program Evaluation
topic Unified Health System
Regional Health Planning
Primary Health Care
Evaluation Studies as Topic
Program Evaluation
description ABSTRACT OBJECTIVE: To analyze the impact of implementing the Contrato Organizativo de Ação Pública (COAP – Public Action Organizational Contract) on the expansion of access to primary care in the states of Ceará and Mato Grosso do Sul. METHODS: We used the interrupted time series method to analyze the effect of COAP on primary care coverage (PCCov) and on avoidable hospitalization rates. To analyze the effects of increased PCCov on avoidable hospitalizations, we used non-segmented time series models. RESULTS: The results showed that implementing COAP had a positive impact on increased coverage in both cases, with did not happen in the control states. However, this impact was not reflected in the decrease in hospitalizations due to primary care sensitive conditions (HPCSC) or for acute preventable causes. When we analyzed the effects of the increase in PCCov on avoidable hospitalizations between 2009 and 2016, we observed that coverage had a positive impact on the decrease in the rate of HPCSC only in Ceará, although hospitalizations have a significant trend to decrease in time both in this state and in Mato Grosso do Sul, except for acute respiratory infections. CONCLUSIONS: The COAP continues to be the regulatory instrument of regionalization force, however, the results obtained by adhering to it in the expansion of primary care in Ceará and Mato Grosso do Sul makes us question whether the contractual model, as predicted, is the best instrument for advancing regionalization in the Brazilian Unified Health System.
publishDate 2021
dc.date.none.fl_str_mv 2021-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102021000100214
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102021000100214
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.11606/s1518-8787.2021055003001
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Faculdade de Saúde Pública da Universidade de São Paulo
publisher.none.fl_str_mv Faculdade de Saúde Pública da Universidade de São Paulo
dc.source.none.fl_str_mv Revista de Saúde Pública v.55 2021
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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