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基层医疗团队与家庭健康支持单位之间的协调及其对基层医疗服务的影响。

Coordination between Primary Care Teams and Family Health Support Units and influence on Primary Care delivery.

机构信息

Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal da Paraíba (UFPB). Campus I, Lot. Cidade Universitária. 58051-900 João Pessoa PB Brasil.

Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Medicina, Departamento de Saúde Coletiva, Universidade Federal de Juiz de Fora. Juiz de Fora MG Brasil.

出版信息

Cien Saude Colet. 2022 Jun;27(6):2495-2508. doi: 10.1590/1413-81232022276.03942021. Epub 2021 Nov 5.

Abstract

This article aims to compare the implementation of coordinated actions by family health/primary care (FH/PC) teams and extended family health and primary care units (NASF-ABs) in the Northeast and rest of Brazil, and the influence of implementation on collaborative working. The independent variables were 19 coordinated actions assessed by Module II of the 3rd Cycle of the National Program for Improving Primary Care Access and Quality (PMAQ-AB). The three collaborative working outcomes were "FH/PC team readiness to work jointly with the NASF-AB", "support received by the FH/PC team from the NASF-AB", and "The NASF-AB's contribution to resolving patients" needs. The implementation of coordinated actions by the Northeast and at national level was compared using the two-proportions z-test and the influence of these actions on the outcomes was assessed using hierarchical linear regression models: The Northeast implemented more actions that at national level (p<0.05). The implemented actions that had the most positive influence on the three outcomes were "Case conferences", "Joint development of singular therapy plans for complex cases", "Shared appointments" and "Results monitoring". The Northeast implemented more actions and the implemented actions had a positive influence on collaborative working.

摘要

本文旨在比较东北和巴西其他地区家庭健康/初级保健(FH/PC)团队和扩展家庭健康和初级保健单位(NASF-AB)实施协调行动的情况,以及实施情况对协作工作的影响。自变量为第 3 轮国家改善初级保健获取和质量计划(PMAQ-AB)第二模块评估的 19 项协调行动。三个协作工作结果是“FH/PC 团队准备与 NASF-AB 共同工作”、“FH/PC 团队从 NASF-AB 获得的支持”和“NASF-AB 对解决患者需求的贡献”。使用双比例 z 检验比较东北和全国的协调行动实施情况,使用层次线性回归模型评估这些行动对结果的影响:东北实施的行动比全国更多(p<0.05)。对三个结果影响最积极的实施行动是“病例会议”、“联合制定复杂病例的单一治疗计划”、“共享预约”和“结果监测”。东北实施了更多的行动,这些行动对协作工作产生了积极的影响。

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