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[治疗糖尿病患者的基层医疗单位结构:巴西国家改善医疗可及性与质量计划的第一和第二周期]

[Structure of primary healthcare units for treating persons with diabetes: Cycles I and II of the Brazilian National Program to Improve Access and Quality].

作者信息

Neves Rosália Garcia, Duro Suele Manjourany Silva, Muñiz Javier, Castro Teresa Rosalia Pérez, Facchini Luiz Augusto, Tomasi Elaine

机构信息

Universidade Federal de Pelotas, Pelotas, Brasil.

Universidade da Coruña, Coruña, España.

出版信息

Cad Saude Publica. 2018 Mar 29;34(4):e00072317. doi: 10.1590/0102-311X00072317.

DOI:10.1590/0102-311X00072317
PMID:29617486
Abstract

The objective was to describe the necessary structure for treating diabetes patients in the primary healthcare system, as evaluated in Cycles I and II of the Brazilian National Program for the Improvement of Access and Quality (PMAQ) in 2012 and 2014, according to the municipalities' characteristics. A descriptive study was used to assess primary care units whose teams participated in Cycles I and II of the PMAQ in 2012 and 2014. The study used variables from Module I of the external evaluation of the PMAQ that addresses the primary care units' structure. Materials (150kg scale, sphygmomanometer, adult stethoscope, tape measure, blood glucose monitor, monofilament packs, ophthalmoscope, and capillary blood glucose strips); medicines (NPH and regular insulin, glyburide, and metformin); and physical space (clinical consultation room, pharmacy, reception/waiting room, and meeting room). All the medicines and the reception/waiting room increased by more than 10p.p. from 2012 to 2014. The prevalence rates for adequate structure of materials, medicines, and physical space in the primary care units were higher in 2014. Adequate structure increased as follows: for materials, from 3.9% to 7.8%, for medicines, from 31.3% to 49.9%, for physical space, from 15.3% to 23.3%. Municipalities with more than 300,000 inhabitants, higher Human Development Index (HDI), and lower coverage of the Family Health Strategy (FHS) showed higher prevalence rates for adequate primary care units. Units that adhered to Cycles I and II of the PMAQ showed improvement in their structures. However, there was a low prevalence of primary care units with adequate structures, besides differences in the services' structure according to population size, HDI, and FHS coverage.

摘要

目的是描述2012年和2014年巴西国家改善医疗服务可及性和质量计划(PMAQ)第一和第二周期中,根据各市镇特点,在初级卫生保健系统中治疗糖尿病患者所需的结构。采用描述性研究评估2012年和2014年其团队参与PMAQ第一和第二周期的初级保健单位。该研究使用了PMAQ外部评估模块I中涉及初级保健单位结构的变量。材料(150千克秤、血压计、成人听诊器、卷尺、血糖仪、单丝包、检眼镜和毛细血管血糖试纸);药品(中性胰岛素和正规胰岛素、格列本脲和二甲双胍);以及物理空间(临床咨询室、药房、接待/候诊室和会议室)。从2012年到2014年,所有药品以及接待/候诊室增加了超过10个百分点。2014年初级保健单位中材料、药品和物理空间结构充足的患病率更高。结构充足率的增长如下:材料方面,从3.9%增至7.8%;药品方面,从31.3%增至49.9%;物理空间方面,从15.3%增至23.3%。居民超过30万、人类发展指数(HDI)较高且家庭健康战略(FHS)覆盖率较低的市镇,初级保健单位结构充足的患病率更高。参与PMAQ第一和第二周期的单位其结构有所改善。然而,结构充足的初级保健单位患病率较低,此外,服务结构还因人口规模;HDI和FHS覆盖率而存在差异。

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