Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
J Epidemiol Community Health. 2011 Jun;65(6):483-90. doi: 10.1136/jech.2008.077172. Epub 2010 Dec 10.
The Family Health Strategy (FHS) has been implemented as a strategy for primary care improvement in Brazil. Working with teams that include one doctor, one nurse, auxiliary nurses and community health workers in predefined areas, the FHS began in 1994 (known then as the Family Health Program) and has since grown considerably. The programme has only recently undergone assessment of outcomes, in contrast to more routine evaluations of infrastructure and process.
In 2001, a health survey was carried out in two administrative districts (with 190,000 inhabitants) on the outskirts of the city of São Paulo, both partially served by the FHS. Chronic morbidity (hypertension, diabetes and ischaemic heart disease) of individuals aged 15 or older was studied in areas covered and not covered by the programme. Stratified univariate analysis was applied for sex, age, education, income, working status and social insurance of these populations. Multivariate analysis was applied where applicable.
There was a distinct pattern in the morbidity profile of these populations, suggesting differentiated self-knowledge on chronic disease status in the areas served by the FHS.
The FHS can increase population awareness of chronic diseases, possibly through increasing access to primary care.
家庭健康策略（FHS）作为改善巴西初级保健的策略已经实施。该策略与包括一名医生、一名护士、助理护士和社区卫生工作者在内的团队合作，在预先确定的区域内开展工作，于 1994 年开始实施（当时称为家庭健康计划），此后规模不断扩大。与基础设施和流程的常规评估相比，该计划最近才对结果进行评估。
2001 年，在圣保罗市郊区的两个行政区（拥有 19 万居民）进行了一项健康调查，这两个行政区均部分由 FHS 提供服务。在覆盖和未覆盖该计划的地区，研究了年龄在 15 岁及以上人群的慢性病发病率（高血压、糖尿病和缺血性心脏病）。对这些人群的性别、年龄、教育、收入、工作状况和社会保险进行了分层单变量分析。在适用的情况下应用了多变量分析。
这些人群的发病情况存在明显的模式，表明在 FHS 服务的地区，慢性病状况的自我认知存在差异。
FHS 可以通过增加对初级保健的获取，提高人群对慢性病的认识。
