Ponce Maria Amélia Zanon, Wysocki Anneliese Domingues, Scatolin Beatriz Estuque, Andrade Rubia Laine de Paula, Arakawa Tiemi, Ruffino Netto Antonio, Monroe Aline Aparecida, Scatena Lucia Marina, Vendramini Sílvia Helena Figueiredo, Villa Tereza Cristina Scatena
Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil.
Cad Saude Publica. 2013 May;29(5):945-54.
This cross-sectional study aimed to analyze the first health service to which patients turned for tuberculosis diagnosis in São José do Rio Preto, São Paulo, Brazil, 2009. Eighty-one patients in treatment were interviewed with a questionnaire based on the Primary Care Assessment Tool adapted to TB care and used as a reference for health services performance (structure and process). Data analysis used descriptive and multiple correspondence techniques. Nearly half of the patients initially came to emergency care departments (49.4%), and most TB diagnoses were made in hospitals (39.5%) and primary care services (30.9%). Specialized services were associated with the best diagnostic performance, as opposed to emergency departments, with the worst performance. Primary care services were associated with intermediate performance and weaknesses in infrastructure. The reach of effective detection of TB cases in the portals of entry into the health system involves enhanced diagnostic suspicion, thus emphasizing the need for investments in the management of human resources training for the identification of individuals with respiratory symptoms.
这项横断面研究旨在分析2009年巴西圣保罗州里奥普雷图河畔圣若泽的患者首次寻求结核病诊断的医疗服务机构。采用基于适应结核病护理的初级保健评估工具的问卷，对81名正在接受治疗的患者进行了访谈，并将该问卷用作医疗服务绩效（结构和流程）的参考。数据分析采用描述性和多重对应技术。近一半的患者最初前往急诊科（49.4%），大多数结核病诊断在医院（39.5%）和初级保健服务机构（30.9%）进行。与急诊科相反，专科服务的诊断表现最佳，而急诊科的表现最差。初级保健服务的表现处于中等水平，且基础设施存在薄弱环节。在卫生系统的入口处有效检测结核病病例，需要提高诊断怀疑度，因此强调需要投资于人力资源培训管理，以识别有呼吸道症状的个体。
