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巴西社区卫生工作者未进行家访的患病率及相关因素。

Prevalence of not receiving a home visit by Community Health Agents in Brazil and associated factors.

作者信息

Kessler Marciane, Thumé Elaine, Facchini Luiz Augusto, Tomasi Elaine

机构信息

Curso de Enfermagem, Universidade Regional Integrada do Alto Uruguai e das Missões (URI Erechim). Av. Sete de Setembro 1621, Fátima. 99709-910 Erechim RS Brasil.

Programa de Pós-Graduação em Epidemiologia, UFPel. Pelotas RS Brasil.

出版信息

Cien Saude Colet. 2022 Nov;27(11):4253-4263. doi: 10.1590/1413-812320222711.17072021. Epub 2022 Jul 2.

Abstract

This article aimed to identify the prevalence of not receiving a home visit by a community health agent (CHA) and the factors associated with it. This was a cross-sectional study, conducted with 38,865 health teams and 140,444 users in the entire country, who participated in the external evaluation of the Program of Access and Quality Improvement in Primary Health (PMAQ-AB, in Portuguese) in 2017/2018. The association between not receiving a home visit by a CHA and the characteristics of the towns, teams, and individuals were estimated by the prevalence ratio (PR) with 95% confidence intervals. The prevalence of not receiving a home visit by a CHA was 18.6% and the main causes were: CHA did not visit the home, lack of knowledge of the existence of CHAs in the neighborhood or unit, and no one present at the home when the CHA visited. The probability of receiving a home visit was higher in poorer regions like the Northeast Region of the country; in towns with a smaller population; among older age users with a lower income, users with chronic health conditions, or users who have someone with a physical disability at home. The results showed that there is a need to increase the coverage of CHA visits in the country, considering that their home visits improve equity in health care.

摘要

本文旨在确定未接受社区卫生工作者(CHA)家访的发生率及其相关因素。这是一项横断面研究,研究对象为全国38865个卫生团队和140444名用户,他们参与了2017/2018年初级卫生保健准入与质量改善计划(葡萄牙语为PMAQ-AB)的外部评估。通过患病率比(PR)及95%置信区间来估计未接受CHA家访与城镇、团队及个人特征之间的关联。未接受CHA家访的发生率为18.6%,主要原因包括:CHA未上门家访、社区或单位居民对CHA的存在缺乏了解、CHA家访时家中无人。在该国较贫困地区如东北地区,接受家访的可能性更高;在人口较少的城镇;在收入较低的老年用户、患有慢性健康问题的用户或家中有肢体残疾者的用户中,接受家访的可能性更高。结果表明,鉴于CHA家访有助于提高医疗保健公平性,该国需要扩大CHA家访的覆盖范围。

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