Departamento de Enfermagem, Núcleo de Estudos e Pesquisas Epidemiológicas, Universidade Estadual da Paraíba, Campina Grande, PB, Brasil.
Rev Saude Publica. 2009 Oct;43(5):825-31. doi: 10.1590/s0034-89102009005000054. Epub 2009 Sep 18.
To assess the access to tuberculosis treatment in healthcare services with Programa Saúde da Família (PSF - Family Health Program) and at a reference outpatient clinic.
A descriptive inquiry was carried out in 2007 with 106 patients who received tuberculosis treatment through the PSF or the reference outpatient clinic in Campina Grande, Northeastern Brazil, from July 2006 to August 2007. To assess the health services, the instrument Primary Care Assessment Tool was used, validated and adapted to assess tuberculosis care in Brazil. The main variables analyzed referred to the transportation and distance to the service and patients' supervision.
Of the 106 patients, 83.9% performed self-administered treatment and 16.0% received supervised treatment. The indicators from the PSF units and from the reference outpatient clinic that were similar (p>0.05) were: 65.1% 'losing half work day to attend the medical visit'; 65.0% 'having to use motorized transport'; 50.0% 'always having to pay for motorized transport'; and 69.0% 'not receiving treatment at healthcare units near home'. The indicators 'using motorized transport', 'paying for transport to attend the medical visit' and 'receiving treatment near home' were statistically different (p<0.05) between the services. Standardized and non-standardized Cronbach's alpha coefficients were, respectively, 0.7275 and 0.7075, based on the eight items of the questionnaire.
Although the city has 85 PSF teams, supervised treatment was carried out by few health workers. Although the tuberculosis treatment is offered by the public health service, it still represents a cost to the patients, due to the distance to the healthcare service and losing half work day in order to attend medical visits.
评估在有 Programa Saúde da Família（PSF-家庭健康计划）和参考门诊的医疗服务中获得结核病治疗的途径。
2007 年，在巴西东北部坎皮纳格兰德进行了一项描述性调查，调查对象为 2006 年 7 月至 2007 年 8 月期间通过 PSF 或参考门诊接受结核病治疗的 106 名患者。为了评估卫生服务，使用了经过验证和适用于巴西评估结核病护理的初级保健评估工具。主要分析变量涉及到患者前往服务机构的交通和距离以及患者监督。
在 106 名患者中，83.9%进行自我管理治疗，16.0%接受监督治疗。PSF 单位和参考门诊的指标相似（p>0.05）：65.1%“因看医生而损失半天工作时间”；65.0%“需要使用机动交通工具”；50.0%“总是需要支付机动交通费用”；69.0%“在离家近的医疗机构得不到治疗”。使用机动交通工具、支付医疗就诊交通费和在离家近的地方接受治疗这三个指标在服务机构之间存在统计学差异（p<0.05）。基于问卷的 8 个项目，标准化和非标准化 Cronbach's alpha 系数分别为 0.7275 和 0.7075。
尽管该市有 85 个 PSF 团队，但只有少数卫生工作者提供监督治疗。尽管结核病治疗是由公共卫生服务提供的，但由于距离医疗机构较远以及为了看医生而损失半天工作时间，患者仍需承担费用。
