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卫生专业人员评估的初级卫生保健:传统模式与家庭健康战略的比较

Primary health care as assessed by health professionals: comparison of the traditional model versus the Family Health Strategy.

作者信息

Flôr Cristina Rabelo, Oliveira Cláudia Di Lorenzo, Cardoso Clareci Silva, Rabelo Cleonice Ferreira, Gontijo Bernardo Luis, Carvalho Suzana Freitas de, Bretas Pedro Messenger Caldeira, Silva Hygor Cabral, Pereira Mariana Linhares, Pádua Cristiane Menezes de

机构信息

Grupo de Pesquisas em Epidemiologia e Avaliação de Novas Tecnologias em Saúde, Universidade Federal de São João del-Rei - Divinópolis (MG), Brazil.

Departamento de Farmácia Social, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.

出版信息

Rev Bras Epidemiol. 2017 Oct-Dec;20(4):714-726. doi: 10.1590/1980-5497201700040013.

Abstract

INTRODUCTION

The Family Health Strategy (FHS) should be first-contact care in the Brazilian Health System. However, Primary Health Care (PHC) still encompasses two models: the FHS and the traditional health care facilities. The expansion of the FHS has been slow and heterogeneous in many cities, rendering a comparative evaluation of key quality-related elements of PHC models crucial.

OBJECTIVE

To compare the performance of PHC models as perceived by health professionals.

METHODS

A cross-sectional study involving managers and health professionals from PHC of a medium-size city in South-eastern Brazil. Data were collected by applying the Primary Care Assessment Tool. The performance was estimated through primary health care indexes (general and partial PHCI by attributes). Univariate polytomous logistic regression was performed to compare care model performances according to their attributes. Strength of association was estimated by odds ratio with 95% confidence interval.

RESULTS

Three managers and 81 health professionals participated in the study. The FHS had a better index rating than the traditional care model for general PHCI and for the attributes longitudinality, comprehensiveness, family focus and professional level.

CONCLUSION

Although the FHS attained higher scores compared to the traditional model, it has not yet achieved the performance expected. This scenario points to the need for increased FHS cover and quality improvements at the existing units.

摘要

引言

家庭健康战略(FHS)应是巴西卫生系统中的首诊医疗服务。然而,初级卫生保健(PHC)仍包含两种模式:家庭健康战略和传统卫生保健机构。在许多城市,家庭健康战略的扩展缓慢且不均衡,因此对初级卫生保健模式中与质量相关的关键要素进行比较评估至关重要。

目的

比较卫生专业人员所感知的初级卫生保健模式的绩效。

方法

一项横断面研究,涉及巴西东南部一个中等规模城市初级卫生保健机构的管理人员和卫生专业人员。通过应用初级保健评估工具收集数据。通过初级卫生保健指标(按属性划分的总体和部分初级卫生保健指数)评估绩效。进行单变量多分类逻辑回归,以根据其属性比较不同医疗模式的绩效。通过比值比和95%置信区间估计关联强度。

结果

三名管理人员和81名卫生专业人员参与了该研究。在总体初级卫生保健指数以及纵向性、全面性、家庭导向和专业水平等属性方面,家庭健康战略的指数评分高于传统医疗模式。

结论

尽管与传统模式相比,家庭健康战略获得了更高的分数,但尚未达到预期的绩效。这种情况表明需要扩大家庭健康战略的覆盖范围,并提高现有机构的质量。

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