scholarly journals Gestão do cuidado e matriciamento na atenção primária à saúde: um relato de experiência

2021 ◽  
Vol 3 (2) ◽  
pp. 95-101
Author(s):  
Minéia da Costa Figueiredo ◽  
Fabiana Lopes de Paula

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.

2021 ◽  
Vol 3 (2) ◽  
pp. 102-109
Author(s):  
Lucas Gaspar Ribeiro ◽  
Daiane Marcondes

Um marco para a saúde no Brasil foi a implantação do Programa Saúde da Família (PSF) em 1994, com a reorientação das práticas assistenciais pelos princípios doutrinários e organizacionais do Sistema Único de Saúde. Esse sistema também oferta as práticas integrativas e complementares, abordando o indivíduo na sua multidimensionalidade, estimulando os mecanismos naturais de cura. Elas foram inseridas como política pública em 2006, no mesmo ano que o PSF foi modificado para estratégia. Ambas possuem relevantes afinidades e pontos que fortalecem o cuidado. O objetivo desse artigo é apresentar essa aproximação teórico-prática através de uma revisão narrativa, encontrando diversas premissas e ferramentas de cuidado compartilhados pela abordagem da Atenção Primária à Saúde (APS) e pelas práticas integrativas e complementares, além das práticas contribuindo para a desmedicalização, acesso e resolutividade da APS com o trabalho interprofissional, individualmente e coletivamente.       Palavras-chave: atenção primária à saúde, práticas integrativas e complementares, estratégia saúde da família, políticas públicas em saúde, sistema único de saúde.   Abstract A milestone for health in Brazil was the implementation of the Programa Saúde da Família (PSF) in 1994, with the reorientation of care practices based on doctrinal and organizational principles of the Unified Health System. This system also offers integrative and complementary practices, addressing the individual in its multidimensionality, stimulating the natural healing mechanisms. They were inserted as public policy in 2006, at the same year that the PSF was changed to strategy. Both contain affinities and points that strengthen care. The objective of the article is to present this theoretical-practical approach of a narrative review, finding several premisse and tools of care shared by the approach of Primary Health Care (PHC) and by integrative and complementary practices, in addition to the practices contributing to demedicalization, access and resolution of PHC with interprofessional work, individually and collective Keywords: primary health care, integrative and complementary practices, family health strategy, public health policy, unified health system.


2019 ◽  
Vol 72 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Leonardo Barbosa Rolim ◽  
Janássia Gondim Monteiro ◽  
Anya Pimentel Gomes Fernandes Vieira Meyer ◽  
Sharmênia de Araújo Soares Nuto ◽  
Márcio Flávio Moura de Araújo ◽  
...  

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.


2018 ◽  
Vol 52 ◽  
pp. 78
Author(s):  
Luciano José Arantes ◽  
Helena Eri Shimizu ◽  
Edgar Merchán-Hamann

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.


Bionorte ◽  
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 ◽  
...  

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.


2019 ◽  
Vol 13 ◽  
Author(s):  
Josué Souza Gleriano ◽  
Priscila Corrêa da Luz Zaiaz ◽  
Angélica Pereira Borges ◽  
Grasiela Cristina Lucietto ◽  
Priscila Balderrama ◽  
...  

Objetivo: descrever a percepção de uma equipe multiprofissional da Estratégia Saúde da Família sobre a organização do processo de trabalho na sua unidade. Método: trata-se de estudo qualitativo, descritivo, desenvolvido numa unidade de saúde com 11 profissionais, utilizando a técnica de grupo focal, norteada pela Autoavaliação para Melhoria do Acesso e da Qualidade da Atenção Básica na dimensão de organização do processo de trabalho. Submeteu-se os dados à técnica de Análise de Conteúdo. Resultados: aponta-se que, na organização dos dados, emergiram duas categorias: Aspectos organizacionais e Aspectos relacionais. Enfatizam-se a importância do enfermeiro para a coordenação das ações e a necessidade de se fomentar o trabalho colaborativo para a integralidade das ações. Conclusão: constata-se a necessidade de se instituir, no âmbito da equipe de saúde, a reflexão rotineira sobre a organização dos processos de trabalho pautada nos atributos da atenção primária à saúde, além da prática de avaliação como ferramenta para melhorar a qualidade da atenção. Descritores: Organização e Administração; Atenção Primária à Saúde; Saúde da Família; Equipe de Assistência ao Paciente; Serviços Básicos de Saúde; Serviços de Saúde.Abstract Objective: to describe the perception of a multiprofessional Family Health Strategy team about the organization of the work process in their unit. Method: this is a qualitative, descriptive study, developed in a health unit with 11 professionals, using the focus group technique, guided by the Self-Assessment for Improving Access and Quality of Primary Care in the dimension of work process organization. The data was submitted to the technique of Content Analysis. Results: it is pointed out that, in the data organization, two categories emerged: Organizational Aspects and Relational Aspects. Emphasize the importance of nurses for the coordination of actions and the need to encourage collaborative work for the integrality of actions. Conclusion: there is a need to establish, within the health team, routine reflection on the organization of work processes based on the attributes of primary health care, in addition to the practice of evaluation as a tool to improve the quality of care. Descritores: Organization and Administration; Primary Health Care; Family Health; Patient Care Team; Basic Health Servicesb; Health Services. Resumen Objetivo: describir la percepción de un equipo multiprofesional de Estrategia de Salud Familiar sobre la organización del proceso de trabajo en su unidad. Método: este es un estudio cualitativo, descriptivo, desarrollado en una unidad de salud con 11 profesionales, utilizando la técnica de grupo de enfoque, guiado por la Autoevaluación para mejorar el acceso y la calidad de la atención primaria en la dimensión de la organización del proceso de trabajo. Los datos fueron sometidos a la técnica de Análisis de Contenido. Resultados: se señala que, en la organización de datos, surgieron dos categorías: Aspectos organizacionales y Aspectos relacionales. Se enfatiza la importancia de las enfermeras para la coordinación de las acciones y la necesidad de fomentar el trabajo colaborativo para la integralidad de las acciones. Conclusión: es necesario establecer, dentro del equipo de salud, una reflexión rutinaria sobre la organización de los procesos de trabajo basados en los atributos de la atención primaria de salud, además de la práctica de la evaluación como una herramienta para mejorar la calidad de la atención. Descritores: Organización y Administración; Atención Primaria de Salud; Salud de la Familia; Grupo de Atención al Paciente; Servicios Básicos de Salud; Servicios de Salud.


2021 ◽  
pp. e1-e10
Author(s):  
Marciane Kessler ◽  
Elaine Thumé ◽  
Michael Marmot ◽  
James Macinko ◽  
Luiz Augusto Facchini ◽  
...  

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 )


PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0201723 ◽  
Author(s):  
Monica Viegas Andrade ◽  
Augusto Quaresma Coelho ◽  
Mauro Xavier Neto ◽  
Lucas Resende de Carvalho ◽  
Rifat Atun ◽  
...  

2017 ◽  
Vol 20 (4) ◽  
pp. 714-726 ◽  
Author(s):  
Cristina Rabelo Flôr ◽  
Cláudia Di Lorenzo Oliveira ◽  
Clareci Silva Cardoso ◽  
Cleonice Ferreira Rabelo ◽  
Bernardo Luis Gontijo ◽  
...  

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.


2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Bruno Pereira Nunes ◽  
Mariangela Uhlmann Soares ◽  
Louriele Soares Wachs ◽  
Pâmela Moraes Volz ◽  
Mirelle de Oliveira Saes ◽  
...  

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.


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

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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