scholarly journals Presence and extension of the attributes of primary health care in public dental services in Porto Alegre, Rio Grande do Sul State, Brazil

2020 ◽  
Vol 36 (2) ◽  
Author(s):  
Débora Deus Cardozo ◽  
Juliana Balbinot Hilgert ◽  
Caroline Stein ◽  
Lisiane Hauser ◽  
Erno Harzheim ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Services ◽  
Assessment Tool ◽  
Evaluation Instrument ◽  
Primary Health ◽  
Care Assessment ◽  
Oral Health Services

The objective was to compare the presence and extension of primary health care (PHC) in oral health services using the PHC attributes according to three different types of PHC organizational arrangements: Family Health Strategy (FHS), Community Health Service (CHS) and Traditional Primary Care (TPC). This is a cross-sectional study carried out between 2011-2013, following a cluster random sampling strategy. Adult users were interviewed from 15 health services of that 6 were managed by the CHS, 4 by the FHS and 5 by the TPC and which had the same oral health team for at least two years. The final sample was 407 users interviewed using the Primary Care Assessment Tool - Oral Health of Adults evaluation instrument and a sociodemographic questionnaire. PHC scores were calculated and transformed on a scale ranging from 0 to 10. For high scores, the cut-off point > 5.5 was used. Most of the interviewees were females, for the three types of services. The performance of CHS and FHS was higher than those of TPC in almost all attributes (p < 0.05). The extent of PHC attributes in services was poor (overall highest score was 5.75 in CHS). The CHS was the only service witch half of the users (83; 49.1%) rated oral health services as having a high overall score for PHC. It is concluded that there were differences among the organizational arrangements of PHC oral health services, however, there is much to be improved in the orientation of dental care services for PHC. More studies are necessary to evaluate the differences in PHC services considering oral health.

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 Construction and Validation of a Tool for the Assessment of the Oral Health in Primary Health Care Through the Perspective of Patients

2020 ◽  
Vol 12 (4) ◽  
pp. 37
Author(s):  
Heriberto Fiuza Sanchez ◽  
Raquel Conceição Ferreira ◽  
Andrea Maria Duarte Vargas ◽  
Marcos Azeredo Furquim Werneck ◽  
Efigênia Ferreira e Ferreira
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Factor Analysis ◽  
Primary Health Care ◽  
Oral Health ◽  
Focus Group ◽  
Health Services ◽  
Health Unit ◽  
Primary Health ◽  
Oral Health Services

OBJECTIVE: To construct and validate a questionnaire to evaluate the quality of oral health services in primary health care, from patients. METHODS: Initially a theoretical model of evaluation of Primary Health Care was elaborated, based on the evaluation of primary care and integrality in primary care. This model served as the basis for the script of a focus group with patients, aiming to verify the attributes perceived as important for such evaluation. The focus group results substantiated the first version of the questionnaire. Content validation was performed through a committee of experts (five teachers/researchers) and face validation in two pre-tests (37 patients each pre-test). For construct validation, factor analysis was performed and reliability (Kappa coefficient) and internal consistency (Cronbach&#39;s alpha) were verified. RESULTS: Thirty questions were considered for exploratory factor analysis. The anti-image matrix of covariances showed the need to exclude fourteen questions (values &lt;0.5). After this initial analysis, 16 questions remained in the questionnaire. The KMO test, considering the 16 questions, presented a value of 0.84. Cronbach&#39;s alpha was 0.919. The final version contains 16 questions divided into two dimensions: my health unit and the care in my health unit. CONCLUSIONS: The questionnaire allows a strategy that easily evaluates oral health services in primary care, based on the perception of patients.

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals Measuring the quality of primary care in national health surveys: Lessons from Brazil

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Erno Harzheim ◽  
Luiz F. Pinto ◽  
Otávio P. D'Avila ◽  
Lisiane Hauser
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
National Health ◽  
Assessment Tool ◽  
Household Survey ◽  
Ministry Of Health ◽  
Primary Health ◽  
Care Assessment

Background: South Africa started to lead the cross-culturally validation and use of the Primary Care Assessment Tool (PCAT) in Africa, when Professor Bresick filled a gap, as this continent was until then the only one that had never used it in evaluation of primary health care facilities until 2015.Aim: The authors aim to demonstrate that after the consolidation of Bresick’s team to an African version of PCAT, it had been adapted to household survey in Brazil.Methods: In this letter, authors reflect on how Brazil had adapted PCAT to a national random household survey with Brazilian National Institute of Geography and Statistics (IBGE) – the Brazilian Census Bureau.Results: In the the beginning of 2019, Brazilian Ministry of Health brought back the PCAT as the official national primary health care assessment tool. Brazilian National Institute of Geography and Statistics (IBGE) included a new module (set of questions) in its National Health Survey (PNS-2019) and collected more than 100 000 households interviews in about 40% of the country’s municipalities. This module had 25 questions of the Brazilian validated version of the adult reduced PCAT.Conclusion: We believe that IBGE innovation with the Ministry of Health can encourage South Africa to establish a similar partnership with its National Institute of Statistics (Statistics South Africa) for the country to establish a baseline for future planning of primary health care, for decision-making based on scientific evidence.

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

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 ◽  
...  
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.

scholarly journals Evaluation of primary health care for children under 5 years old in the municipality of lagarto-se

2020 ◽  
pp. 758-766
Author(s):  
Adênia Káren Cardoso Costa ◽  
Anne Katherine Nascimento Mesquita ◽  
Anny Giselly Milhome Milhome da Costa Farre ◽  
Karenine Maria Holanda Cavalcante ◽  
Maria do Socorro Claudino Barreiro
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Primary Health ◽  
Care Assessment ◽  
Primary Care Assessment Tool ◽  
Children Under 5

Objetivo: avaliar a efetividade da assistência primária as crianças menores de cinco anos de idade cadastradas em uma Clínica de Saúde da Família, Lagarto-SE. Método: trata-se de uma pesquisa de resultados, de abordagem quantitativa e delineamento transversal, no qual se utilizou Primary Care Assessment Tool – Versão Criança para avaliação dos atributos de acesso, longitudinalidade, coordenação, integralidade, orientação familiar e orientação comunitária. Resultados: foram entrevistados 50 adultos, responsáveis por crianças de até cinco anos de idade cadastradas no serviço. A avaliação foi positiva para o grau de afiliação e o atributo coordenação-sistema de informações, e os demais não alcançaram o escore mínimo de referência. Conclusão: os atributos revelam há barreiras no acesso ao serviço, falha na continuidade do atendimento, fragilidade na referência e contra-referência e comprometimento na comunicação profissionais de saúde-paciente.

scholarly journals A Survey About Dental Instruments at the Primary Health Care in Brazil

2018 ◽  
Vol 29 (5) ◽  
pp. 500-506
Author(s):  
Joyce Lopes ◽  
Andréa Clemente Palmier ◽  
Marcos Azeredo Furquim Werneck ◽  
Antônio Thomaz Gonzaga da Matta-Machado ◽  
Mauro Henrique Nogueira Guimarães de Abreu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Services ◽  
Social Issues ◽  
Organizational Characteristics ◽  
Care Organization ◽  
Dental Instruments ◽  
Primary Health ◽  
Oral Health Services

Abstract This study describes the structure of oral health services in primary health care in Brazil and the instruments available for the provision of oral health care and to compare the number of instruments according to organizational characteristics of health services and among the macroregions. Of the 23,251 oral health teams (OHTs) in the Public Health System, 17,513 (75.3%) participated in this study. Trained researchers observed the structures of the health services and determined the presence of and whether a sufficient quantity of 36 dental instruments existed. The score of each oral health service was determined by the sum of the number of dental instruments present in sufficient quantity (0 to 36). Central tendency measures were compared along with the variability in these scores according to the organizational characteristics of the services and according to the Brazilian macroregion. No instrument was found to be present in all evaluated services. Basic, surgical and restorative instruments were the most frequently found. Periodontal, endodontic and prosthetic instruments exhibited the lowest percentages. The mean and median numbers of dental instruments were higher for teams that operated over more shifts, those with an oral health technician and those in the South and Southeast regions. The oral health services were equipped with basic, surgical and restorative instruments. Instruments designed for periodontal diagnosis, emergency care and denture rehabilitation were less frequently found in these services. The worst infrastructure conditions existed in the OHTs with the worst forms of care organization and in regions with greater social issues.

scholarly journals Impact of patient-perceived quality of primary health care on the patients' bypass behaviour in China

2020 ◽  
Author(s):  
WeiWei Zhang ◽  
Yuankai Huang ◽  
Gaojie Li ◽  
Hongjie Zhou ◽  
Xiaoyu Xi
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Perceived Quality ◽  
Health Care Facilities ◽  
Primary Health ◽  
Care Assessment ◽  
The Impact

Abstract Background Patient bypass often occurs under the loose gatekeeper system. Additionally, patients’ perceived quality of primary health care (PHC) is one of the important factors affecting bypass behaviour. Objective to explore individuals’ bypass behaviour in China and the associations between patients’ perceived quality of PHC and their bypass behaviour. MethodIn 2019, this study investigated Chinese bypass behaviour and the potential influencing factors. The questionnaire that was used assessed the following: the perceived quality of primary care using the Primary Care Assessment Tool; bypass experience; age; health insurance; and other factors. A logit regression model was used to analyse the impact of perceived quality of PHC on bypass behaviour. Results The data of 2070 residents in 706 health care facilities in China were collected. The results show that perceived quality of PHC is significantly associated with bypass behaviour in China. After adjustments were made for patients’ sociodemographic and other characteristics, an increase of one standard deviation (SD; odds ratio (OR) per 1-SD increase) in the PCAT scores led to a 2% decrease in bypass behaviour (OR 0.98, p<0.05). Gender, hukou and cold fee for PHC were negatively associated with bypass behaviour. Conclusion Patients' perceptions of PHC service quality play an active role in reducing their bypass behaviour, which may provide a new perspective for the design of PHC health policies.

scholarly journals Structural characteristics of oral health services in Brazilian Primary Health Care

2021 ◽  
Vol 35 ◽  
Author(s):  
Maria Tereza Abreu SCALZO ◽  
Antônio Thomaz Gonzaga MATTA-MACHADO ◽  
Mauro Henrique Nogueira Guimarães ABREU ◽  
Renata Castro MARTINS
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Oral Health ◽  
Health Services ◽  
Structural Characteristics ◽  
Primary Health ◽  
Oral Health Services

scholarly journals Primary health care assessment tools: a literature review and metasynthesis

2014 ◽  
Vol 19 (12) ◽  
pp. 4851-4860 ◽  
Author(s):  
Lislaine Aparecida Fracolli ◽  
Maria Fernanda Pereira Gomes ◽  
Fabiana Rodrigues Zequini Nabão ◽  
Mariana Souza Santos ◽  
Verusca Kelly Cappellini ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Assessment Tool ◽  
Primary Care Providers ◽  
Assessment Tools ◽  
Care Providers ◽  
Primary Health ◽  
Care Assessment ◽  
Primary Care Assessment Tool

This study comprises a systematic review and metasynthesis of qualitative literature on national and international databases to identify the main tools used to assess Primary Health Care (PHC). A total of 3,048 results were returned for literature written in Portuguese, Spanish and English published between 1979 and 2013. Thirty-three articles/studies were selected after thorough reading and analysis. Eight of these studies addressed the use of one or more of the following validated PHC assessment tools: the WHO Primary Care Assessment Tool (PCET); the ADHD Questionnaire for Primary Care Providers (AQ-PCP); the General Practice Assessment Questionnaire (GPAQ), PACOTAPS (primary health care software); and the PCAT (Primary Care Assessment Tool). The study showed that the majority of these tools were used internationally. The PCAT and EUROPEP were used in Brazil and the most commonly used tool in this country was the PCAT. The results show that the use of research tools to assess PHC may assist in the creation of new proposals to improve family healthcare and that PCAT is the most adequate tool for this purpose.

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