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残疾和非残疾使用者对初级卫生保健的评估。

Primary health care assessment by users with and without disabilities.

作者信息

Almeida Maria Helena Morgani de, Pacheco Samanta, Krebs Stephanie, Oliveira Amanda Manso, Samelli Alessandra, Molini-Avejonas Daniela Regina, Toldrá Rosé Colom, Oliver Fátima Corrêa

机构信息

Universidade de São Paulo - USP - São Paulo (SP) Brasil.

出版信息

Codas. 2017 Oct 26;29(5):e20160225. doi: 10.1590/2317-1782/20172016225.

Abstract

PURPOSE

To evaluate the core (First Contact, Longitudinality, Comprehensiveness, and Coordination of Services) and derivative (Family Orientation, Community Orientation) attributes of primary health care (PHC) from the perspective of users with and without disabilities.

METHODS

Observational, cross-sectional study using the Primary Care Assessment Tool (PCAT) with users with and without disabilities of five basic health units (BHU) in a municipality where 55% of the population depends on the Brazilian Unified Health System (SUS). Scores were assigned to the responses given to each of the PHC attributes evaluated.

RESULTS

Study participants were 93 (67 physically disabled and 26 without disabilities) PHC users. No statistically significant differences were observed for any attribute on the comparison between the populations. For both groups, the attributes Degree of Affiliation, First Contact - Utilization, Longitudinality, and Coordination of Services - Information System received satisfactory (above cutoff) scores, whereas the attributes First Contact - Accessibility, Coordination of Services - Care Integration, Comprehensiveness, Family Orientation, and Community Orientation received unsatisfactory (below cutoff) scores. Users reported that the health teams are able to satisfactorily identify mobility issues, but there are failures in the recognition of problems of hearing, voice/speech and vision, and in the orientation of services available and services provided.

CONCLUSION

Users with and without disabilities evaluated the health care received similarly, indicating fragilities on the recognition of specific demands. Structural and work process changes should be conducted to ensure Accessibility, Comprehensiveness, and Family and Community Orientation, and thus increase the quality of PHC.

摘要

目的

从残疾和非残疾使用者的角度评估初级卫生保健(PHC)的核心属性(首次接触、连续性、全面性和服务协调性)以及衍生属性(家庭导向、社区导向)。

方法

采用初级保健评估工具(PCAT)对某城市五个基本卫生单位(BHU)的残疾和非残疾使用者进行观察性横断面研究,该城市55%的人口依赖巴西统一卫生系统(SUS)。对评估的每个初级卫生保健属性的回答进行评分。

结果

研究参与者为93名初级卫生保健使用者(67名身体残疾者和26名非残疾者)。在两组人群的比较中,未观察到任何属性有统计学显著差异。对于两组而言,隶属程度、首次接触 - 利用、连续性以及服务协调性 - 信息系统等属性获得了满意(高于临界值)分数,而首次接触 - 可及性、服务协调性 - 护理整合、全面性、家庭导向和社区导向等属性获得了不满意(低于临界值)分数。使用者报告称,卫生团队能够令人满意地识别行动问题,但在听力、语音/言语和视力问题的识别以及可用服务和提供服务的导向方面存在不足。

结论

残疾和非残疾使用者对所接受的医疗保健评价相似,表明在识别特定需求方面存在薄弱环节。应进行结构和工作流程变革,以确保可及性、全面性以及家庭和社区导向,从而提高初级卫生保健质量。

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