Wysocki Anneliese Domingues, Ponce Maria Amélia Zanon, Brunello Maria Eugênia Firmino, Beraldo Aline Ale, Vendramini Silvia Helena Figueiredo, Scatena Lúcia Marina, Ruffino Antonio, Villa Tereza Cristina Scatena
Universidade Federal de Mato Grosso do Sul - Três Lagoas (MS), Brasil.
Faculdade de Ceres - São José do Rio Preto (SP), Brasil.
Rev Bras Epidemiol. 2017 Jan-Mar;20(1):161-175. doi: 10.1590/1980-5497201700010014.
: In order to control tuberculosis, the Brazilian Ministry of Health recommends the decentralization of control actions directed to the Primary Health Care, and there are few studies on the performance of the Tuberculosis Control Program in decentralized contexts.
: To evaluate the performance of Primary Health Care services in tuberculosis treatment.
: This is an evaluative study with cross-sectional approach conducted in 2011. Two hundred and thirty-nine health professionals from Primary Health Care units were interviewed using a structured instrument based on the evaluation reference of the health services quality (structure - process - results). The performance of these services was analyzed applying techniques of descriptive statistics, validation, and construction of indicators and by determining the reduced variable "Z".
: The indicators "participation of professionals in tuberculosis patients' care" (structure) and "reference and counterreference" (process) had the best evaluations, whereas "professional training" (structure) and "external actions for tuberculosis control" (process) had the worst results.
: The decentralization of tuberculosis control actions has been taking place in a vertical manner in Primary Health Care. The challenge of controlling tuberculosis involves overcoming constraints related to the engagement, training, and turnover rates among health professionals, which is a coordination between services and monitoring of control actions in Primary Health Care.
为了控制结核病，巴西卫生部建议将针对初级卫生保健的控制行动进行分权，而关于结核病控制项目在分权背景下的绩效研究较少。
评估初级卫生保健服务在结核病治疗方面的绩效。
这是一项于2011年采用横断面研究方法的评估性研究。使用基于卫生服务质量评估参考（结构 - 过程 - 结果）的结构化工具，对来自初级卫生保健单位的239名卫生专业人员进行了访谈。运用描述性统计、验证、指标构建技术以及确定简化变量“Z”的方法，对这些服务的绩效进行了分析。
“专业人员参与结核病患者护理”（结构）和“转诊与反向转诊”（过程）指标的评估结果最佳，而“专业培训”（结构）和“结核病控制外部行动”（过程）的结果最差。
结核病控制行动在初级卫生保健中一直以垂直方式进行分权。控制结核病的挑战涉及克服与卫生专业人员的参与度、培训和人员流动率相关的制约因素，这是初级卫生保健中服务协调和控制行动监测的问题。
