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获得初级卫生保健的可能性:《获得与质量改进国家计划》的数据显示了什么?

Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

作者信息

Uchôa Severina Alice da Costa, Arcêncio Ricardo Alexandre, Fronteira Inês Santos Estevinho, Coêlho Ardigleusa Alves, Martiniano Claudia Santos, Brandão Isabel Cristina Araújo, Yamamura Mellina, Maroto Renata Melo

机构信息

Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.

Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

Rev Lat Am Enfermagem. 2016;24:e2672. doi: 10.1590/1518-8345.1069.2672. Epub 2016 Mar 4.

Abstract

OBJECTIVE

to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access.

METHOD

a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used.

RESULTS

the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions.

CONCLUSION

areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil.

摘要

目的

分析背景指标对巴西各市在初级卫生保健潜在可及性方面表现的影响,并探讨护士在这种可及性方面所做贡献。

方法

一项基于国家初级保健可及性与质量提升计划外部评估的多中心描述性研究,有17202个初级保健团队参与。采用比例卡方检验来验证根据覆盖区域规模、供应、协调和整合分层的各市之间的差异;必要时,采用耶茨校正卡方检验或费舍尔精确检验。对于人口变量,采用克鲁斯卡尔 - 沃利斯检验。

结果

大多数参与者是护士(n = 15876;92.3%)。在各市之间,在地域(p = 0.0000)、可及性(p = 0.0000)、护理协调(p = 0.0000)、整合(p = 0.0000)和供应(p = 0.0000)方面观察到具有统计学意义的差异,证实构成第6区域的各市在这些维度上往往表现更好。

结论

在每个分析维度上,第4、5和6区域表现更好,并且护士在巴西初级卫生保健可及性潜力方面发挥了主导作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab09/4822689/25961b412d55/0104-1169-rlae-02672-gf01.jpg

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