Departamento de Medicina Social, Universidade Federal de Pelotas, Pelotas, RS, Brasil.
Rev Saude Publica. 2010 Dec;44(6):1102-11. doi: 10.1590/s0034-89102010005000038. Epub 2010 Sep 17.
To assess factors associated with home health care for the elderly and its characteristics based on different care models, the Family Health Strategy and traditional primary care.
A population-based cross-sectional study was conducted in a representative sample of 1,593 individuals aged >60 years living in the urban area of the city of Bagé, Southern Brazil, in 2008. A multistage sampling was carried out. Data was collected during individual interviews about access to services, providers' involvement, users' satisfaction and health status after care. Poisson regression model was used for estimating crude and adjusted prevalence ratios, their related 95% confidence intervals and p-values (Wald test).
Home health care was statistically associated with prior history of stroke, signs of dementia and disability in activities of daily living. The family was requested 75% of home care visits. Medical doctors provided most of the care in traditional primary care settings while nursing staff provided most care within the Family Health Strategy. Approximately 78% of the elderly received care within 24 hours after the request and 95% of them positively evaluated the care received. Two thirds of the elderly reported improved health status.
The variables associated with home health care were consistent with fragility indicators included in the Brazilian National Health Policy for the Elderly, reinforcing the role of this strategy for promoting equitable health care to elderly population. Users' satisfaction and the positive impact on their health status confirm home as a setting for providing care.
根据不同的照护模式（家庭健康策略和传统基层医疗），评估与老年人家庭医疗照护相关的因素及其特点。
本研究为基于人群的横断性研究，于 2008 年在巴西巴伊亚州城市Bagé 的城区中抽取了一个有代表性的 1593 名年龄大于 60 岁的人群样本。采用多阶段抽样。通过个人访谈收集关于服务可及性、提供者参与、用户满意度和护理后健康状况的数据。采用泊松回归模型估计粗患病率比及其相关的 95%置信区间和 p 值（Wald 检验）。
家庭医疗照护与既往卒中史、痴呆症状和日常生活活动能力障碍显著相关。家庭被要求进行 75%的家庭护理访问。在传统基层医疗环境中，医生提供了大部分的护理，而在家庭健康策略中，护士提供了大部分的护理。大约 78%的老年人在需求提出后 24 小时内得到了护理，其中 95%的老年人对所接受的护理给予了积极评价。三分之二的老年人报告称健康状况得到了改善。
与家庭医疗照护相关的变量与巴西国家老年人健康政策中包含的脆弱性指标一致，这强化了该策略在为老年人口提供公平医疗照护方面的作用。用户满意度和对其健康状况的积极影响证实了家庭是提供照护的场所。
