Dos Santos de Sá Francisco, Di Lorenzo Oliveira Cláudia, de Moura Fernandino Débora, Menezes de Pádua Cristiane A, Cardoso Clareci Silva
Research Group in Epidemiology and Evaluation of New Technology in Health, CNPq/UFSJ, Medical School, Federal University of de São João del-Rei, Divinópolis, Minas Gerais, Brazil.
Research Group in Epidemiology and Evaluation of New Technology in Health, CNPq/UFSJ, Medical School, Federal University of de São João del-Rei, Divinópolis, Minas Gerais, Brazil, Department of Social Pharmacy, Federal Universidade of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil and.
Fam Pract. 2016 Jun;33(3):243-8. doi: 10.1093/fampra/cmv096. Epub 2015 Nov 30.
The hospitalization for ambulatory care sensitive conditions (ACSC) has been used to assess the effectiveness of primary health care (PHC). Due to the existence of different models of organization of PHC in Brazil, it is important to develop indicators and tools for their assessment.
Assessment PHC from the perspective of patients hospitalized for ACSC.
A cross-sectional study was carried out. The patients were interviewed for assessment of PHC quality using the primary care assessment tool and a questionnaire. Descriptive analyses were performed and the Primary Health Care Index (PHCI) was calculated according to the health service modality, either the traditional primary health care (TPHC) or the Family Health Program (FHP). The PHCI of the two health care models were compared.
A total of 314 ACSC patients were interviewed 26.4% from the FHP and 73.6% from the TPHC. In general, the PHCI dimension with the lowest score was health service access. There was no significant difference in the general PHCI for the two modalities of services (P = 0.16); however, comprehensiveness was better assessed in the TPHC, while longitudinality, family focus and community orientation were better evaluated by FHP users (P ≤ 0.05).
The FHP was found to be better qualified to establish longitudinality in the community, an important dimension for continued care. However, promoting access to and consolidating a proactive care model focussed on family shows to be a great challenge for the implementation of a quality and resolutive PHC in large urban centres.
门诊医疗敏感疾病（ACSC）的住院治疗已被用于评估初级卫生保健（PHC）的有效性。由于巴西存在不同的初级卫生保健组织模式，因此开发评估指标和工具很重要。
从因ACSC住院的患者角度评估初级卫生保健。
进行了一项横断面研究。使用初级保健评估工具和问卷对患者进行访谈，以评估初级卫生保健质量。进行了描述性分析，并根据卫生服务模式（传统初级卫生保健（TPHC）或家庭健康计划（FHP））计算了初级卫生保健指数（PHCI）。比较了两种卫生保健模式的PHCI。
共访谈了314例ACSC患者，其中26.4%来自家庭健康计划，73.6%来自传统初级卫生保健。总体而言，得分最低的PHCI维度是卫生服务可及性。两种服务模式的总体PHCI无显著差异（P = 0.16）；然而，传统初级卫生保健对综合性的评估更好，而家庭健康计划的使用者对纵向性、家庭关注和社区导向的评估更好（P≤0.05）。
发现家庭健康计划更有资格在社区建立纵向性，这是持续护理的一个重要维度。然而，在大城市中心实施高质量和果断的初级卫生保健，促进获得并巩固以家庭为重点的积极护理模式是一项巨大挑战。
