Correction: Transition to universal primary health care coverage in Brazil: Analysis of uptake and expansion patterns of Brazil’s Family Health Strategy (1998–2012)

Este artigo irá abordar a vivência em uma unidade de Estratégia Saúde da Família (ESF) no município de Canto do Buriti-PI sobre os aspectos relacionados ao processo de matriciamento e a gestão do cuidado. A descrição será feita a partir da análise da gestão do cuidado e articulações com o Núcleo de Apoio à Saúde da Família (NASF) e suas ações de apoio matricial desenvolvidas na unidade. O NASF tem fundamental importância na resolução de casos mais complexos e na efetivação de cuidado integral, bem como para a assistência humanizada aos usuários na Atenção Primária à Saúde. O relato traz como contribuição a análise do processo de trabalho entre eSF e NASF, com uma visão que traz subsídios para a reflexão; tendo a intenção de cooperar para o aperfeiçoamento, progresso das ações na APS e a concretização das políticas públicas. Palavras-chave: Atenção Primária à Saúde; Estratégia Saúde da Família; Equipe de Assistência ao Paciente; Integralidade em Saúde; Sistema Único de Saúde. Abstract This article will address the experience in a Family Health Strategy (ESF) unit in the city of Canto do Buriti-PI on aspects related to the matrix support process and care management. The description will be made from the analysis of care management and articulations with the Family Health Support Center (NASF) and its matrix support actions developed in the unit. The NASF is of fundamental importance in solving more complex cases and in providing comprehensive care, as well as in providing humanized assistance to users in Primary Health Care. The report contributes to the analysis of the work process between eSF and NASF, with a a vision that supports reflection; with the intention of cooperating for the improvement, progress of actions in the PHC and the implementation of public policies. Keywords: Primary Health Care; Family Health Strategy; Patient Care Team; Integrality in Health; Unified Health System.

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Evaluation of Primary Health Care attributes of Fortaleza city, Ceará State, Brazil

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0033 ◽

2019 ◽

Vol 72 (1) ◽

pp. 19-26 ◽

Cited By ~ 1

Author(s):

Leonardo Barbosa Rolim ◽

Janássia Gondim Monteiro ◽

Anya Pimentel Gomes Fernandes Vieira Meyer ◽

Sharmênia de Araújo Soares Nuto ◽

Márcio Flávio Moura de Araújo ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Assessment Tool ◽

Family Health ◽

A Value ◽

Primary Health ◽

Health Strategy ◽

Care Assessment ◽

Family Health Strategy

ABSTRACT Objective: To evaluate the Primary Health Care attributes of Fortaleza city, Ceará State. Method: Evaluative study carried out at 97 Primary Health Care Units, from August 2015 to June 2016. 451 professionals from the Family Health Strategy participated in the study. We used the Primary Care Assessment Tool - Brazil, which evaluates the attributes, assigning scores on a scale of zero to ten. We adopted as a cut-off point, to consider high Primary Care score, attributes with a value of 6.60 or higher. Results: Among the eight attributes evaluated the First Contact Access and the Coordination - Information System were the ones that obtained the lowest and highest scores, (2.98) and (7.82), respectively. The Overall Score, calculated by means of a mean of the attributes, was 6.34. Conclusion: The Primary Care evaluated had a low score, showing the need to discuss mechanisms to boost the attributes that obtained low scores.

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Ambulatory care sensitive hospitalizations after implementation of the master plan in Minas Gerais

Revista de Saúde Pública ◽

10.11606/s1518-8787.2018052017330 ◽

2018 ◽

Vol 52 ◽

pp. 78

Author(s):

Luciano José Arantes ◽

Helena Eri Shimizu ◽

Edgar Merchán-Hamann

Keyword(s):

Health Care ◽

Primary Health Care ◽

Ambulatory Care ◽

Family Health ◽

Master Plan ◽

Primary Health ◽

Health Strategy ◽

Family Health Strategy ◽

Ambulatory Care Sensitive Hospitalizations ◽

Ambulatory Care Sensitive

OBJECTIVE: To describe the rate of ambulatory care sensitive hospitalizations in groups of cities according to population size and to analyze its association with the coverage of the Family Health Strategy after the implementation of the Master Plan for Primary Health Care in Minas Gerais, Brazil. METHODS: This is an ecological study with 452 cities grouped according to population size, with data from 2004 to 2007 and 2010 to 2013. We used the Kolmogorov-Smirnov test to verify the distribution of the data in the groups. We used the Wilcoxon test for paired data or the paired Student’s t-test to compare the rate of ambulatory care sensitive hospitalizations before and after the Master Plan for Primary Health Care. We used the simple linear regression test to analyze the association between variables. We performed statistical analyses using the Statistical Package for the Social Sciences, with a significance level of 5%. RESULTS: The rate of ambulatory care sensitive hospitalizations decreased significantly after the Master Plan for Primary Health Care in the large and mid-sized groups (p < 0.05). There were positive correlations between coverage with Family Health Strategy and the rate of ambulatory care sensitive hospitalizations in the mid-sized and large groups (p < 0.05). CONCLUSIONS: Actions were carried out to implement the Master Plan for Primary Health Care. However, more investments are needed to improve the effectiveness of the Primary Health Care, with permanent confrontation of complex issues that affect the quality of services, which can lead to a significant reduction of the rates of ambulatory care sensitive hospitalizations.

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Avaliação dos atributos essenciais da atenção primária em Montes Claros –MG

Bionorte ◽

10.47822/2526-6349.2021v10n1p134 ◽

2021 ◽

Vol 10 (1) ◽

pp. 134-142

Author(s):

Ludmila Cotrim Fagundes ◽

Caio Fagundes Quadros Lima ◽

Luciana Cristine Dias ◽

Maria Alice Miranda Fortes ◽

André Augusto Dias Silveira ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Family Health ◽

Descriptive Study ◽

Primary Health ◽

Level Of Satisfaction ◽

Health Strategy ◽

Family Health Strategy ◽

The City

Objective:to evaluate the essential attributes of primary care in a Family Health Strategy in the city of Montes Claros -MG from the perspective of the assisted population. Materials and Methods:this is a quantitative and descriptive study, with a sample of 130 patients. The Sociodemographic Questionnaire and the Questionnaire for the Evaluation of the Attributes of Primary Care were applied between the months of September and October 2018. The results were tabulated in an Excel spreadsheet. Results:the four Essential Attributes of Primary Care were mostly answered with a reasonable level of satisfaction or above. Overall average satisfaction was 6.8 points. Conclusion:the reduction of waiting time for appointments with general practitioners and the absence of specialists in the FHS were the main demands. However, in the eyes of users, it was evident that the four Essential Attributes of Primary Health Care, in general, are well exerted.

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Family Health Strategy, Primary Health Care, and Social Inequalities in Mortality Among Older Adults in Bagé, Southern Brazil

American Journal of Public Health ◽

10.2105/ajph.2020.306146 ◽

2021 ◽

pp. e1-e10

Author(s):

Marciane Kessler ◽

Elaine Thumé ◽

Michael Marmot ◽

James Macinko ◽

Luiz Augusto Facchini ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Social Inequalities ◽

Family Health ◽

Primary Health ◽

Health Strategy ◽

Family Health Strategy ◽

Inequalities In Mortality

Objectives. To investigate the role of the Family Health Strategy (FHS) in reducing social inequalities in mortality over a 9-year follow-up period. Methods. We carried out a population-based cohort study of individuals aged 60 years and older from the city of Bagé, Brazil. Of 1593 participants at baseline (2008), 1314 (82.5%) were included in this 9-year follow-up (2017). We assessed type of primary health care (PHC) coverage and other variables at baseline. In 2017, we ascertained 579 deaths through mortality registers. Hazard ratios and their 95% confidence intervals modeled time to death estimated by Cox regression. We also tested the effect modification between PHC and wealth. Results. The FHS had a protective effect on mortality among individuals aged 60 to 64 years, a result not found among those not covered by the FHS. Interaction analysis showed that the FHS modified the effect of wealth on mortality. The FHS protected the poorest from all-cause mortality (hazard ratio [HR] = 0.59; 95% confidence interval [CI] = 0.36, 0.96) and avoidable mortality (HR = 0.46; 95% CI = 0.25, 0.85). Conclusions. FHS coverage reduced social inequalities in mortality among older adults. Our findings highlight the need to guarantee universal health coverage in Brazil by expanding and strengthening the FHS to promote health equity. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e10. https://doi.org/10.2105/AJPH.2020.306146 )

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Primary health care as assessed by health professionals: comparison of the traditional model versus the Family Health Strategy

Revista Brasileira de Epidemiologia ◽

10.1590/1980-5497201700040013 ◽

2017 ◽

Vol 20 (4) ◽

pp. 714-726 ◽

Cited By ~ 4

Author(s):

Cristina Rabelo Flôr ◽

Cláudia Di Lorenzo Oliveira ◽

Clareci Silva Cardoso ◽

Cleonice Ferreira Rabelo ◽

Bernardo Luis Gontijo ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Professionals ◽

Family Health ◽

Traditional Model ◽

Care Model ◽

Primary Health ◽

Health Strategy ◽

The Family ◽

Family Health Strategy

ABSTRACT: Introduction: The Family Health Strategy (FHS) should be first-contact care in the Brazilian Health System. However, Primary Health Care (PHC) still encompasses two models: the FHS and the traditional health care facilities. The expansion of the FHS has been slow and heterogeneous in many cities, rendering a comparative evaluation of key quality-related elements of PHC models crucial. Objective: To compare the performance of PHC models as perceived by health professionals. Methods: A cross-sectional study involving managers and health professionals from PHC of a medium-size city in South-eastern Brazil. Data were collected by applying the Primary Care Assessment Tool. The performance was estimated through primary health care indexes (general and partial PHCI by attributes). Univariate polytomous logistic regression was performed to compare care model performances according to their attributes. Strength of association was estimated by odds ratio with 95% confidence interval. Results: Three managers and 81 health professionals participated in the study. The FHS had a better index rating than the traditional care model for general PHCI and for the attributes longitudinality, comprehensiveness, family focus and professional level. Conclusion: Although the FHS attained higher scores compared to the traditional model, it has not yet achieved the performance expected. This scenario points to the need for increased FHS cover and quality improvements at the existing units.

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Hospitalization in older adults: association with multimorbidity, primary health care and private health plan

Revista de Saúde Pública ◽

10.1590/s1518-8787.2017051006646 ◽

2017 ◽

Vol 51 (0) ◽

Cited By ~ 4

Author(s):

Bruno Pereira Nunes ◽

Mariangela Uhlmann Soares ◽

Louriele Soares Wachs ◽

Pâmela Moraes Volz ◽

Mirelle de Oliveira Saes ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Primary Health Care ◽

Health Plan ◽

Family Health ◽

Care Model ◽

Primary Health ◽

Health Strategy ◽

Family Health Strategy ◽

Health Care Model

ABSTRACT OBJECTIVE Evaluate the association of multimorbidity, primary health care model and possession of a private health plan with hospitalization. METHODS A population-based cross-sectional study with 1,593 elderly individuals (60 years old or older) living in the urban area of the city of Bagé, State of Rio Grande do Sul, Brazil. The outcome was hospitalization in the year preceding the interview. The multimorbidity was evaluated through two cut-off points (≥ 2 and ≥ 3). The primary health care model was defined by residence in areas covered by traditional care or by Family Health Strategy. The older adults mentioned the possession of a private health plan. We performed a gross and adjusted analysis by Poisson regression using a hierarchical model. The adjustment included demographic, socioeconomic, functional capacity disability and health services variables. RESULTS The occurrence of overall and non-surgical hospitalization was 17.7% (95%CI 15.8–19.6) and 10.6% (95%CI 9.1–12.1), respectively. Older adults with multimorbidity were admitted to hospitals more often when to older adults without multimorbidity, regardless of the exhibition’ form of operation. Having a private health plan increased the hospitalization by 1.71 (95%CI 1.09–2.69) times among residents in the areas of the Family Health Strategy when compared to elderly residents in traditional areas without a private health plan. CONCLUSIONS The multimorbidity increased the occurrence of hospitalizations, especially non-surgical ones. Hospitalization was more frequent in older adults with private health plan and those living in Family Health Strategy areas, regardless of the presence of multiple diseases.

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Resistência antimicrobiana na pneumonia adquirida na comunidade: revisão de literatura

VITTALLE - Revista de Ciências da Saúde ◽

10.14295/vittalle.v33i3.12659 ◽

2021 ◽

Vol 33 (3) ◽

pp. 76-88

Author(s):

Carolina Henrique Da Silva ◽

Rosimar Xavier de Oliveira ◽

Andréia Patrícia Gomes ◽

Tiago Ricardo Moreira ◽

Luciene Muniz Braga

Keyword(s):

Health Care ◽

Drug Resistance ◽

Primary Health Care ◽

Streptococcus Pneumoniae ◽

Family Health ◽

Primary Health ◽

Health Strategy ◽

Bacterial Drug Resistance ◽

De Se ◽

Family Health Strategy

A resistência antimicrobiana é um fator importante para a abordagem da Pneumonia Adquirida na Comunidade, uma das principais causas de morte por doenças infecciosas no mundo. A presente revisão de literatura objetiva analisar a resistência bacteriana relacionada aos principais antimicrobianos usados para o tratamento da Pneumonia Adquirida na Comunidade, na Atenção Primária à Saúde, no mundo e no Brasil. Foram realizadas pesquisas com oito associações composta por quatro dos seguintes descritores: “Pneumonia”, “Brazil”, “Family Health Strategy”, “Primary Health Care”, “Anti-Bacterial Agents”, “Drug Resistance, Bacterial”, “Drug Resistance, Microbial” e “Antimicrobial Stewardship”. As bases de dados utilizadas foram: Pubmed/Medline, Google Scholar, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Portal de Periódicos Capes/MEC e Research Gate, considerando o período de maio a junho de 2020. Após a análise, dez estudos foram incluídos, com ausência de resultados concernentes ao Brasil. Os trabalhos obtidos referiram-se à resistência nos países europeus (sete), nos Estados Unidos (dois) e no Malawi (um). O Streptococcus pneumoniae apresentou-se como o patógeno bacteriano de maior prevalência nessa infecção. Os resultados sugerem a importância de se estabelecer diretrizes para o tratamento da Pneumonia Adquirida na Comunidade de acordo com o perfil epidemiológico de cada região. No Brasil, especificamente, as dificuldades no manejo dessa condição, realizado regularmente de forma empírica, podem ser explicadas pela ausência de estudos dirigidos a essa temática, tornando-se fundamental a realização de investigações da realidade brasileira.

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Which older people in the community have the highest clinical-functional vulnerability?

Geriatrics Gerontology and Aging ◽

10.53886/gga.e0210027 ◽

2021 ◽

Vol 15 ◽

Author(s):

Aline Martins Alves ◽

Nathália de Oliveira Andrade ◽

Maria Eduarda Leite Facina ◽

Beatriz Rodrigues de Souza Melo ◽

Aline Cristina Martins Gratão ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Primary Health Care ◽

Older People ◽

Social Isolation ◽

Family Health ◽

Primary Health ◽

Health Strategy ◽

Low Education ◽

Family Health Strategy

OBJECTIVE: To identify the factors related to clinical-functional vulnerability in older people. METHODS: This cross-sectional quantitative study was conducted in 2018/2019 with 492 older adults registered in Family Health Strategy units in the city of Três Lagoas, MS, Brazil. Sociodemographic data were collected and the Clinical-Functional Vulnerability Index (CFVI-20) was applied (possible score 0-40; higher scores indicate greater vulnerability). A multinomial logistic regression was performed to identify the risk factors for clinical-functional vulnerability. RESULTS: The sample’s mean age was 70.80 years (SD, 7.82) and the mean CFVI-20 score was 9.25 (SD, 7.09), with 17.07% at high risk of clinical-functional vulnerability, 38.82% at moderate risk, and 44.11% at low risk. Low education, social isolation, difficulty sleeping, and being female were risk factors for moderate vulnerability. On the other hand, low education, social isolation, difficulty sleeping, physical inactivity, being female, not using alcohol, and not participating in social groups were risk factors for high vulnerability. CONCLUSIONS: The CFVI-20 is convenient for primary health care contexts, since it is fast and easy to apply. By recognizing factors related to vulnerability, specific preventive actions can be planned. Keywords: frail elderly; primary health care; family health strategy; health vulnerabilit

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