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排班模式与初级卫生保健质量:一项多层次横断面研究。

Scheduling models and primary health care quality: a multilevel and cross-sectional study.

作者信息

Vidal Tiago Barra, Rocha Suelen Alves, Harzheim Erno, Hauser Lisiane, Tesser Charles Dalcanale

机构信息

Universidade Federal de Santa Catarina. Programa de Pós-Graduação em Saúde Coletiva. Florianópolis, SC, Brasil.

Universidade Estadual Paulista. Programa de Pós-Graduação em Saúde Coletiva. São Paulo, SP, Brasil.

出版信息

Rev Saude Publica. 2019;53:38. doi: 10.11606/S1518-8787.2019053000940. Epub 2019 May 6.

Abstract

OBJECTIVE

To evaluate whether the scheduling model influences the perception of the user about the quality of primary health care centers.

METHODS

This is a cross-sectional and population-based study that measured the quality of centers by the Primary Care Assessment Tool (PCATool-Brazil), applied to adult users (n = 409) from 11 health centers in Florianópolis, state of Santa Catarina. Multilevel analysis was used to verify the relationship between the score of general quality of the primary health care and the scheduling model. The independent variables (age, skin color, scheduling model, panel size by primary health team, poverty ratio as income proxy, number of health teams, presence of economically interest areas, number of medical appointments in one year per primary health team, number of people treated in one year per health team), with p < 0.20 were selected for the multilevel model, which was adjusted with aggregates of information from users and health centers.

RESULTS

The health center that used advanced access had a general score of 7.04, while those using a weekly carve-out had a score of 6.26; the carve-out every 15 days, score of 5.87; and the traditional carve-out, score of 6.29.

CONCLUSIONS

The scheduling model of advanced access had a positive effect on the quality of primary health care, in the perception of users.

摘要

目的

评估排班模式是否会影响用户对初级卫生保健中心质量的认知。

方法

这是一项基于人群的横断面研究,通过应用于圣卡塔琳娜州弗洛里亚诺波利斯11个卫生中心的成年用户(n = 409)的初级保健评估工具(巴西版PCATool)来衡量中心的质量。采用多水平分析来验证初级卫生保健总体质量得分与排班模式之间的关系。将p < 0.20的自变量(年龄、肤色、排班模式、初级卫生团队的小组规模、作为收入替代指标的贫困率、卫生团队数量、经济利益区域的存在情况、每个初级卫生团队每年的医疗预约数量、每个卫生团队每年治疗的人数)纳入多水平模型,并根据用户和卫生中心的信息汇总进行调整。

结果

采用先进预约制的卫生中心总体得分为7.04,而采用每周预留制的得分为6.26;每15天预留制的得分为5.87;传统预留制的得分为6.29。

结论

在用户认知中,先进预约制的排班模式对初级卫生保健质量有积极影响。

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