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巴西各地区对初级卫生保健的用户满意度:来自巴西初级卫生保健评估计划(PMAQ-AB)的第一轮外部评估

User satisfaction with primary health care by region in Brazil: 1st cycle of external evaluation from PMAQ-AB.

作者信息

Protasio Ane Polline Lacerda, Gomes Luciano Bezerra, Machado Liliane Dos Santos, Valença Ana Maria Gondim

机构信息

Pós-Graduação em Modelos de Decisão e Saúde, Universidade Federal da Paraíba (UFPB). Cidade Universitária s/n, Castelo Branco. 58051-900 João Pessoa PB Brasil.

Departamento de Promoção da Saúde, UFPB. João Pessoa PB Brasil.

出版信息

Cien Saude Colet. 2017 Jun;22(6):1829-1844. doi: 10.1590/1413-81232017226.26472015.

Abstract

The National Program for Access and Quality Improvement in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, PMAQ-AB) aimed to improve healthcare public service quality and satisfaction of health service users. This study's objective was to identify the main factors influencing user satisfaction with primary care (PC) services by region in Brazil. Using secondary data from the 1st Cycle of PMAQ-AB, logistic regression models were developed by region, with user satisfaction as the dependent variable, as defined by cluster analysis. Based on the obtained models, the health unit's ability to solve users' problems and feeling respected by the health providers were the most important factors for user satisfaction in all regions in Brazil. However, other important factors by region included the following: the health unit's hours of operation meeting the user's needs (Northeast); providers asking about family members (North); providers asking about other health needs (Midwest); users being seen without an appointment (South); and users asking questions after the appointment (Southeast). In conclusion, the factors influencing user satisfaction with PC vary according to region and are mainly associated with access quality, meeting users' needs, and work process organization.

摘要

国家初级医疗保健可及性与质量提升计划(Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, PMAQ-AB)旨在提高医疗公共服务质量以及医疗服务使用者的满意度。本研究的目的是确定巴西各地区影响初级医疗保健(PC)服务使用者满意度的主要因素。利用PMAQ-AB第一轮的二手数据,按地区建立了逻辑回归模型,将使用者满意度作为聚类分析所定义的因变量。基于所获得的模型,在巴西所有地区,卫生机构解决使用者问题的能力以及被医疗服务提供者尊重的感受是使用者满意度的最重要因素。然而,按地区划分的其他重要因素包括:卫生机构的营业时间满足使用者需求(东北部);提供者询问家庭成员情况(北部);提供者询问其他健康需求(中西部);使用者无需预约即可就诊(南部);以及使用者在预约后提问(东南部)。总之,影响PC使用者满意度的因素因地区而异,主要与可及性质量、满足使用者需求以及工作流程组织有关。

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