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初级保健评估工具 (PCAT):为评估巴西卫生服务建立新的基线。

Primary Care Assessment Tool (PCAT): developing a new baseline for evaluating Brazilian health services.

机构信息

Programa de Pós-Graduação em Atenção Primária à Saúde, Faculdade de Medicina, Universidade Federal do Rio de Janeiro. Av. Presidente Vargas 2863, Cidade Nova. 20210-030 Rio de Janeiro RJ

Programa de Residência em Medicina de Família e Comunidade, Secretaria Municipal de Saúde do Rio de Janeiro. Rio de Janeiro RJ Brasil.

出版信息

Cien Saude Colet. 2021 Feb;26(2):651-656. doi: 10.1590/1413-81232021262.42552020. Epub 2020 Nov 18.

Abstract

In Brazil, within the SUS, Primary Health Care (PHC) gained relevance from the Family Health Strategy's structuring from the 1990s to the 2000s. Several instruments are available in the world to evaluate PHC services, including the family of instruments of the Primary Care Assessment Tool (PCAT), developed and disseminated by Starfield & Shi to assess the existence and extent of the features of primary health care services. Reinforcing the importance of using this instrument in Brazil, the Ministry of Health published in 2020 a new edition of the Brazilian version that informs the methodology used for such instruments, reviving the role of IBGE as a significant external evaluator of the SUS. The IBGE pioneered in its primary household random sample survey, the National Health Survey, a question-based module of the reduced version of the PCAT for adult users. The leading global results found for Brazil (overall PCAT score=5.9) inform that those who use PHC services (adults with referred morbidities) the most are also those who evaluate these services most positively. Differences were also observed among the residents of households registered by the family health teams, those receiving visits from the community and endemic workers, and age groups (older people evaluate services more positively).

摘要

在巴西,全民健康覆盖体系(SUS)中,初级卫生保健(PHC)自 20 世纪 90 年代至 21 世纪初,随着家庭健康战略的构建而变得尤为重要。全球有多种工具可用于评估 PHC 服务,包括由 Starfield 和 Shi 开发和推广的初级保健评估工具(PCAT)家族,用于评估初级卫生保健服务的特征的存在和程度。为了加强在巴西使用该工具的重要性,卫生部于 2020 年发布了新版本的巴西语版,该版本提供了此类工具的使用方法,重新确立了 IBGE 作为 SUS 外部重要评估者的作用。IBGE 在其初级家庭随机抽样调查——国家健康调查中率先采用了基于问题的 PCAT 简化版模块,用于成年用户。针对巴西的全球领先结果(总体 PCAT 评分为 5.9)表明,最常使用 PHC 服务(有转诊疾病的成年人)的人也是对这些服务评价最高的人。在家庭健康团队登记的居民、接受社区和地方病工作人员访问的居民以及年龄组之间也观察到了差异(老年人对服务的评价更为积极)。

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