Bousquat Aylene, Giovanella Ligia, Fausto Marcia Cristina Rodrigues, Fusaro Edgard Rodrigues, Mendonça Maria Helena Magalhães de, Gagno Juliana, Viana Ana Luiza d'Ávila
Faculdade de Saúde Publica, Universidade de São Paulo, São Paulo, Brasil.
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2017 Aug 21;33(8):e00037316. doi: 10.1590/0102-311X00037316.
The structural typology of Brazil's 38,812 primary healthcare units (UBS) was elaborated on the basis of the results from a survey in cycle 1 of the National Program for Improvement in Access and Quality of Primary Care. Type of team, range of professionals, shifts open to the public, available services, and installations and inputs were the sub-dimensions used. For each sub-dimension, a reference standard was defined and a standardized score was calculated, with 1 as the best. The final score was calculated by factor analysis. The final mean score of Brazilian UBS was 0.732. The sub-dimension with the worst score was "installations and inputs" and the best was "shifts open to the public". The primary healthcare units were classified according to their final score in five groups, from best to worst: A, B, C, D, and E. Only 4.8% of the Brazilian UBS attained the maximum score. The typology showed specific characteristics and a regional distribution pattern: units D and/or E accounted for nearly one-third of the units in the North, and two-thirds of units A were situated in the South and Southeast of Brazil. Based on the typology, primary healthcare units were classified according to their infrastructure conditions and possible strategies for intervention, as follows: failed, rudimentary, limited, fair, and reference (benchmark). The lack of equipment and inputs in all the units except for type A limits their scope of action and case-resolution capacity, thus restricting their ability to respond to health problems. The typology presented here can be a useful tool for temporal and spatial monitoring of the quality of infrastructure in UBS in Brazil.
巴西38812个初级卫生保健单位（UBS）的结构类型学是根据国家初级保健服务可及性与质量改善计划第1周期的一项调查结果制定的。团队类型、专业人员范围、向公众开放的班次、可用服务以及设施和投入是所使用的子维度。对于每个子维度，定义了一个参考标准并计算了标准化分数，1分为最佳分数。最终分数通过因子分析计算得出。巴西初级卫生保健单位的最终平均分数为0.732。得分最差的子维度是“设施和投入”，得分最好的是“向公众开放的班次”。初级卫生保健单位根据其最终得分分为从最佳到最差的五组：A、B、C、D和E。只有4.8%的巴西初级卫生保健单位获得了最高分。该类型学显示出特定特征和区域分布模式：D组和/或E组单位占北部单位的近三分之一，A组单位的三分之二位于巴西南部和东南部。基于该类型学，初级卫生保健单位根据其基础设施条件和可能的干预策略分为以下几类：失败型、基本型、有限型、良好型和参考型（基准型）。除A类单位外，所有单位都缺乏设备和投入，这限制了它们的行动范围和病例解决能力，从而限制了它们应对健康问题的能力。这里介绍的类型学可以成为巴西初级卫生保健单位基础设施质量时空监测的有用工具。
