scholarly journals Assessment of public oral healthcare services in Curitiba, Brazil: a cross-sectional study using the Primary Care Assessment Tool (PCATool)

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023283 ◽  
Author(s):  
Antonio Carlos Nascimento ◽  
Simone Tetü Moysés ◽  
Renata Iani Werneck ◽  
Marilisa Carneiro Leão Gabardo ◽  
Samuel Jorge Moysés
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Assessment Tool ◽  
Healthcare Services ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Care Services ◽  
Care Assessment ◽  
Primary Care Assessment Tool

ObjectivesTo compare two different models of public oral health in primary care services, a so-called family health strategy (FHS), as opposed to non-FHS services designated as ‘conventional’ healthcare (CHC), regarding the presence and extent of the attributes of ‘good’ primary healthcare (PHC). The null hypothesis of this study is that the attributes do not differ between the FHS and CHC.DesignCross-sectional.SettingPublic PHC services in Curitiba, the state capital of Paraná.ParticipantsPHC users of the public oral health network (n=900) and dentists active in this municipal network (n=203).Primary and secondary outcome measuresThe Primary Care Assessment Tool (PCATool)-Dentists and PCATool-Users were used to analyse the primary outcomes (‘essential’ attributes) and secondary outcomes (‘derived’ attributes) in the PHC.ResultsOverall, the primary care services in oral health were well evaluated, both by users and by dentists, with mean scores ascribed to PHC attributes mostly above the cut-off point (6.6). The exception for users were affiliation (6.36; 95% CI 6.11 to 6.60) and accessibility (5.83; 95% CI 5.78 to 5.89); and for dentists the accessibility (5.80; 95% CI 5.63 to 5.96). When comparing FHS and CHC, there was a superiority of the FHS model, which reached a general mean score of 7.53 (95% CI 7.48 to 7.58) among users and 7.56 (95% CI 7.45 to 7.67) among dentists; on the other hand, the CHC general mean score was of 6.61 (95% CI 6.49 to 6.73) and 6.68 (95% CI 6.56 to 6.80) respectively for users and dentists.ConclusionsThe results reveal a reasonable level of attainment of PHC attributes in the services investigated. Nevertheless, public health managers should make efforts to reduce the difficulties faced by users in accessing dental care. The more positive results achieved by FHS services indicate that the provision of oral healthcare under this strategy should be expanded.

scholarly journals Innovations in the national household random sampling in Brazilian National Health Survey: results from Starfield and Shi’s adult primary care assessment tool (PCAT)

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Luiz Felipe Pinto ◽  
Otavio Pereira D’Avila ◽  
Lisiane Hauser ◽  
Erno Harzheim
Keyword(s):  
Primary Care ◽  
Health Services ◽  
National Health ◽  
Assessment Tool ◽  
National Health Survey ◽  
Care Services ◽  
Primary Care Services ◽  
Care Assessment ◽  
Primary Care Assessment Tool

Abstract Background Several middle and upper income countries carry out household surveys that seek to trace the profile of access and use of health services. Probably one of the most ambitious examples is Brazil, with its National Health Survey (PNS-2019). We evaluated PNS-2019, presenting in an unprecedented way, one of its innovations, which refer to Starfield and Shi’s adult Primary Care Assessment Tool (PCAT). Methods Based on a cross-sectional study, we evaluated Module H of the PNS-2019, which interviewed a probabilistic sample of about 10,000 adults in 2019 in all 27 Brazilian states. According to the PCAT methodology, an average score equal to or above 6.6 indicates a greater orientation and quality of the evaluated primary care services. Results Brazilian overall PCAT score [5, 9] reveals the need to improve primary health care services across the country. There were no statistically significant differences in the scores by sex (men and women, 5.9), and race (whites 5.9 [5.7; 6.0] and brown / black 5.9 [5.8; 6.0]). On the other hand, there was a difference in terms of age. The elderly evaluated the services in a more positive way (score = 6.1 [6.0; 6.2]), when compared to those aged 40–59 years (5.9 [5.7; 6.0]) and 18 to 39 years (5.6 [5.5; 5.8]). First results of PNS-2019 show that the population that most needs primary care services in SUS is the one with the best perception and the most positive evaluation of the actions and procedures offered in health facilities. Discussion During 2019, Brazil undertook important structural reforms in PHC based on a new financing model with the aim of inducing an improvement in efficiency and strengthening its attributes. It is essential that countries with universal health coverage (UHC) guarantee access to their population and, especially, the most vulnerable, seek better efficiency of these services and regularly assess PHC based on the population’s perception, through an independent methodology that monitor the quality of services and the strength of PHC, generating value for public resources applied to health services.

scholarly journals AVALIAÇÃO DA COORDENAÇÃO DA ATENÇÃO NA PERSPECTIVA DOS PROFISSIONAIS DE SAÚDE

2017 ◽  
Vol 8 (3) ◽  
Author(s):  
Suderlan Sabino Leandro ◽  
Pedro Sadi Monteiro
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Care Coordination ◽  
Assessment Tool ◽  
Family Health ◽  
Continuity Of Patient Care ◽  
Cross Sectional ◽  
Care Assessment ◽  
Distrito Federal ◽  
Primary Care Assessment Tool

Objetivo: avaliar o atributo da “Coordenação da Atenção” sob a perspectiva dos profissionais de saúde. Metodologia: estudo descritivo transversal realizado com 82 profissionais da “Estratégia Saúde da Família” de uma Região Administrativa do Distrito Federal e foi utilizado como instrumento o Primary Care Assessment Tool . Resultados: os profissionais avaliam a coordenação da atenção positivamente, porém, apontam fragilidades em relação aos serviços de referência que não disponibilizam informações úteis sobre o paciente encaminhado. Conclusão: esta pesquisa sugere que a continuidade da assistência ao paciente torna-se comprometida em decorrência da quebra na integração dos serviços, sendo necessário buscar formas de melhorar a comunicação entre os diversos níveis de atenção.Descritores: Avaliação em Saúde, Continuidade da Assistência ao Paciente, Estratégia Saúde da Família.ASSESSMENT OF THE CARE COORDINATION FROM THE PERSPECTIVE OF HEALTH PROFESSIONALSObjective: To assess the features of care coordination from the perspective of health professionals. Methodology: A cross-sectional descriptive study carried out with 82 professionals of the Family Health Strategy of an administrative region of the Federal District, and the Primary Care Assessment Tool was used as the instrument. Results: Professionals evaluate the coordination of care positively but point out weaknesses in relation to referral services that do not provide useful information about the referred patient. Conclusion: This research suggests that the continuity of patient care is compromised due to the breakdown in the integration of services and it is necessary to seek ways to improve communication between the different levels of care.Descriptors: Health Assessment, Continuity of Patient Care, Family Health Strategy.EVALUACIÓN DE LA COORDINACIÓN DE LA ATENCIÓN EN LA PERSPECTIVA DE LOS PROFESIONALES DE SALUDObjetivo: Evaluar el atributo de la “Coordinación de la Atención” bajo la perspectiva de los profesionales de la salud. Metodología: Estudio descriptivo transversal realizado con 82 profesionales de la “Estrategia Salud de la Familia” de una región administrativa del Distrito Federal y fue utilizado como un instrumento de la Herramienta de Evaluación de la Atención Primaria. Resultados: Los profesionales evaluaran la coordinación de la atención positivamente, pero apuntan fragilidades en relación a los servicios de referencia que no ofrecen informaciones útiles sobre el paciente remitido. Conclusión: esta investigación sugiere que la continuidad de la asistencia al paciente se ve comprometida debido a la ruptura en la integración de los servicios, siendo necesario buscar formas de mejorar la comunicación entre los diversos niveles de la atención primaria.Descriptores: Evaluación en Salud, Continuidad de la Asistencia al Paciente, Estrategia Salud de la Familia.

scholarly journals Assessment of the attribute “Community Orientation” from the perspective of primary care adult users

2019 ◽  
Vol 72 (3) ◽  
pp. 632-639 ◽  
Author(s):  
Eduarda Maria Duarte Rodrigues ◽  
Glaucia Margarida Bezerra Bispo ◽  
Milena Silva Costa ◽  
Camila Almeida Neves de Oliveira ◽  
Roberto Wagner Jr Freire de Freitas ◽  
...  
Keyword(s):  
Primary Care ◽  
Assessment Tool ◽  
Cross Sectional ◽  
Community Orientation ◽  
Evaluative Study ◽  
Primary Health ◽  
Care Assessment ◽  
Integration Of Services ◽  
Basic Health Units ◽  
Primary Care Assessment Tool

ABSTRACT Objective: To assess the presence and extension of the attribute “Community Orientation” of Primary Health Care from the perspective of health services adult users from the Municipality of Juazeiro do Norte-CE. Methods: Quantitative, cross-sectional and evaluative study, carried out in 14 Basic Health Units, from October 2016 to June 2017, using the Primary Care Assessment Tool. Results: The attribute assessment was negative, reaching expressive negative responses in the seven districts, with a mean score of 3.8 (±3.8). The Raw Score (RS) reached a mean of 6.6 and the Derived Score (DS) was assigned a score of 6.4, below the cut-off point ≥ 6.60. Conclusion: The low value of the DS represents that units are not providers of PHC, suggesting fragility in the integration of services with the community and the need to promote greater discussion among agents, when designing measures of intervention and improvement of scores.

scholarly journals Validity and reliability of the Brazilian Primary Care Assessment Tool: Oral Health of Adults

2020 ◽  
Vol 23 ◽  
Author(s):  
Débora Deus Cardozo ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Liége Teixeira Fontanive ◽  
Erno Harzheim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Assessment Tool ◽  
Validity And Reliability ◽  
Dental Services ◽  
Primary Health ◽  
Care Assessment ◽  
Primary Care Assessment Tool

ABSTRACT: Objective: To test the factorial validity and reliability of the Primary Care Assessment Tool adapted to Oral Health, adult patient version, an instrument used to verify the presence and extent of attributes in Primary Health Care services. Methods: Population-based cross-sectional study using conglomerate random sample carried out in Primary Health Care Dental services in Porto Alegre between 2011 and 2013. We interviewed 407 adult patients who used Primary Health Care Dental services. Construct validity was tested through factorial validity and reliability of the Primary Care Assessment Tool, that comprises 81 items distributed throughout Primary Health Care attributes. Equamax orthogonal rotation method was used in the factorial analysis; and, in order to assess reliability of each component, we used the item-total correlation and the ratio of success of the scale. Results: In the factorial analysis, 10 factors were retained, explaining 53.3% of the total variation. This result demonstrates the multidimensional structure of the instrument. The reliability assessment showed Cronbach’s alpha values ranging from 0.39 to 0.89. For the success of the scale most of the results (eight of nine attributes) were greater than 85%. Conclusions: The instrument is valid for the assessment of oral health services in Primary Health Care from the perspective of adult patients, as well as for monitoring and evaluation of oral health services in Primary Health Care attributes and comparative studies.

scholarly journals Continuity of care and delivery of diabetes and hypertensive care among regular users of primary care services in Chile: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e027830
Author(s):  
Javiera Leniz ◽  
Martin C Gulliford
Keyword(s):  
Primary Care ◽  
Continuity Of Care ◽  
Cross Sectional Study ◽  
Self Report ◽  
Secondary Outcome ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Care Services

ObjectivesExplore factors related to continuity of care and its association with diabetes and hypertensive care, and disease control.DesignCross-sectional study.SettingData from the Chilean Health National Survey 2009–2010.ParticipantsRegular users of primary care services aged 15 or older.Primary and secondary outcome measuresProportion of hypertensive and diabetic patients with a blood pressure <140/90 mm Hg and HbA1c<7.0% respectively, self-report of diagnosis, treatment and recent foot and ophthalmological exams. Associations between continuity of care, sociodemographic characteristics, and primary and secondary outcomes were explored using logistic regression.Results3887 primary care service users were included. 14.7% recognised a usual GP, 82.3% of them knew their name. Continuity of care was positively associated with age >65 years (OR 4.81, 95% CI 3.16 to 7.32), being female (OR 1.66, 95% CI 1.34 to 2.05), retired (OR 2.22, 95% CI 1.75 to 2.83), obese (OR 1.66, 95% CI 1.29 to 2.14), high cardiovascular risk (OR 2.98, 95% CI 2.13 to 4.17) and widowed (OR 1.50, 95% CI 1.13 to 1.99), and negatively associated with educational level (8–12 vs <8 years OR 0.79, 95% CI 0.64 to 0.97), smoking (OR 0.65, 95% CI 0.52 to 0.82) and physical activity (OR 0.76, 95% CI 0.61 to 0.95). Continuity of care was associated with diagnosis awareness (OR 2.83, 95% CI 1.21 to 6.63), pharmacological treatment (OR 2.04, 95% CI 1.15 to 3.63) and a recent foot (OR 3.17, 95% CI 1.84 to 5.45) and ophthalmological exam (OR 3.20, 95% CI 1.66 to 6.18) in diabetic but not in hypertensive patients.ConclusionsContinuity of care was associated with higher odds of having a recent foot and ophthalmological exam in patients with diabetes, but not with better diseases control. Findings suggest patients with chronic conditions have better continuity of care access.

scholarly journals Primary care doctor and nurse consultations among people who live in slums: a retrospective, cross-sectional survey in four countries

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e054142
Author(s):  
Keyword(s):  
Primary Care ◽  
Traditional Healers ◽  
Primary Care Doctor ◽  
Secondary Outcome ◽  
Health Seeking ◽  
Provider Type ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Services ◽  
Primary Care Services

ObjectivesTo survey on the availability and use of primary care services in slum populations.DesignRetrospective, cross-sectional, household, individual and healthcare provider surveys.SettingSeven slum sites in four countries (Nigeria, Kenya, Pakistan and Bangladesh).ParticipantsResidents of slums and informal settlements.Primary and secondary outcome measuresPrimary care consultation rates by type of provider and facility.ResultsWe completed 7692 household, 7451 individual adult and 2633 individual child surveys across seven sites. The majority of consultations were to doctors/nurses (in clinics or hospitals) and pharmacies rather than single-handed providers or traditional healers. Consultation rates with a doctor or nurse varied from 0.2 to 1.5 visits per person-year, which was higher than visit rates to any other type of provider in all sites except Bangladesh, where pharmacies predominated. Approximately half the doctor/nurse visits were in hospital outpatient departments and most of the remainder were to clinics. Over 90% of visits across all sites were for acute symptoms rather than chronic disease. Median travel times were between 15 and 45 min and the median cost per visit was between 2% and 10% of a household’s monthly total expenditure. Medicines comprised most of the cost. More respondents reported proximity (54%–78%) and service quality (31%–95%) being a reason for choosing a provider than fees (23%–43%). Demand was relatively inelastic with respect to both price of consultation and travel time.ConclusionsPeople in slums tend to live sufficiently close to formal doctor/nurse facilities for their health-seeking behaviour to be influenced by preference for provider type over distance and cost. However, costs, especially for medicines are high in relation to income and use rates remain significantly below those of high-income countries.

scholarly journals Access to primary care for persons with spinal cord injuries in the greater Gaborone area, Botswana

2019 ◽  
Vol 8 ◽  
Author(s):  
Thato M.M. Paulus-Mokgachane ◽  
Surona J. Visagie ◽  
Gubela Mji
Keyword(s):  
Primary Care ◽  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Road Traffic ◽  
Healthcare Services ◽  
Cross Sectional ◽  
Female Ratio ◽  
Care Services ◽  
Primary Care Services ◽  
Cord Injury

Background: People with spinal cord injury (SCI) often have great need for healthcare services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana.Objective: This study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone area, Botswana.Methods: A quantitative, cross-sectional, observational study was conducted. Data were collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive and inferential analysis was performed.Results: The male to female ratio was 2.8:1. The mean age of participants was 40 years (standard deviation 9.59). Road traffic crashes caused 85% of the injuries. Most participants visited primary care facilities between 2 and 10 times in the 6 months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated satisfaction with services. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height-adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs.Conclusion: Primary care services were mostly affordable and adequate. Availability, acceptability and accessibility aspects created barriers.

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