Hospitalizations for ambulatory care-sensitive conditions, Minas Gerais, Southeastern Brazil, 2000 and 2010

OBJECTIVE To analyze hospitalization rates and the proportion of deaths due to ambulatory care-sensitive hospitalizations and to characterize them according to coverage by the Family Health Strategy, a primary health care guidance program. METHODS An ecological study comprising 853 municipalities in the state of Minas Gerais, under the purview of 28 regional health care units, was conducted. We used data from the Hospital Information System of the Brazilian Unified Health System. Ambulatory care-sensitive hospitalizations in 2000 and 2010 were compared. Population data were obtained from the demographic censuses. RESULTS The number of ambulatory care-sensitive hospitalizations declined from 20.75/1,000 inhabitants [standard deviation (SD) = 10.42) in 2000 to 14.92/thousand inhabitants (SD = 10.04) in 2010 Heart failure was the most frequent cause in both years. Hospitalizations rates for hypertension, asthma, and diabetes mellitus, decreased, whereas those for angina pectoris, prenatal and birth disorders, kidney and urinary tract infections, and other acute infections increased. Hospitalization durations and the proportion of deaths due to ambulatory care-sensitive hospitalizations increased significantly. CONCLUSIONS Mean hospitalization rates for sensitive conditions were significantly lower in 2010 than in 2000, but no correlation was found with regard to the expansion of the population coverage of the Family Health Strategy. Hospitalization rates and proportion of deaths were different between the various health care regions in the years evaluated, indicating a need to prioritize the primary health care with high efficiency and quality.

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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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THE FAMILY HEALTH STRATEGY AND HOSPITALIZATIONS IN OLDER ADULTS IN THE NORTHEAST OF BRAZIL

10.5327/z2447-21232021res01 ◽

2021 ◽

Author(s):

Natália Reis de Carvalho ◽

Ana Luiza Carvalho Costa ◽

Andréa Carvalho Araújo Moreira ◽

Samir Gabriel Vasconcelos Azevedo ◽

Naiara Teixeira Fernandes ◽

...

Keyword(s):

Primary Care ◽

Ambulatory Care ◽

Family Health ◽

Ambulatory Care Sensitive Conditions ◽

Hospitalization Rates ◽

Health Strategy ◽

The Family ◽

Family Health Strategy ◽

Ambulatory Care Sensitive ◽

Sensitive Conditions

OBJECTIVE: To analyze the association between the expansion of the Family Health Strategy and hospitalizations for ambulatory care-sensitive conditions in older adults. METHODS: This ecological study was conducted from June to October 2019. The units of analysis were all states in the Northeast of Brazil, and the historical outline included the period from 2008 to 2018. Data on the coverage of the Family Health Strategy and hospitalizations were extracted from the Primary Care Information and Management System and the Hospital Information System. For the association analysis, Spearman coefficients (r) were calculated at a 95% confidence interval (p < 0.05) using STATA, version 13.0. An absolute r value above 0.5 was considered satisfactory. RESULTS: From 2008 to 2018, the Northeast Region recorded a 13.33% increase in the Family Health Strategy coverage and a 27.44% decrease in hospitalization rates. Coverage did not expand in the states of Paraíba, Rio Grande do Norte, and Sergipe; in the latter, there was also no significant reduction in hospitalization rates. There was a correlation between the expansion of the Family Health Strategy and a reduction in hospitalizations for ambulatory care-sensitive conditions in the states of Alagoas (r = −0.9636), Bahia (r = −0.9545), Ceará (r = −0.8884), and Piauí (r = −0.7000). CONCLUSIONS: The results indicate that increased coverage of the Family Health Strategy is associated with greater effectiveness of primary care. However, other intervening factors in hospitalization rates for ambulatory care-sensitive conditions should be considered, such as the health care model and socioeconomic context.

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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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Primary Health Care Evaluation: the view of clients and professionals about the Family Health Strategy

Revista Latino-Americana de Enfermagem ◽

10.1590/0104-1169.0489.2639 ◽

2015 ◽

Vol 23 (5) ◽

pp. 979-987 ◽

Cited By ~ 13

Author(s):

Simone Albino da Silva ◽

Tamara Cristina Baitelo ◽

Lislaine Aparecida Fracolli

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Health ◽

Family Counseling ◽

Primary Health ◽

Health Strategy ◽

Care Assessment ◽

The Family ◽

Community Counseling ◽

Family Health Strategy

Objective: to evaluate the attributes of primary health care as for access; longitudinality; comprehensiveness; coordination; family counseling and community counseling in the Family Health Strategy, triangulating and comparing the views of stakeholders involved in the care process.Method: evaluative research with a quantitative approach and cross-sectional design. Data collected using the Primary Care Assessment Tool for interviews with 527 adult clients, 34 health professionals, and 330 parents of children up to two years old, related to 33 family health teams, in eleven municipalities. Analysis conducted in the Statistical Package for Social Sciences software, with a confidence interval of 95% and error of 0.1.Results: the three groups assessed the first contact access - accessibility with low scores. Professionals evaluated with a high score the other attributes. Clients assigned low score evaluations for the attributes: community counseling; family counseling; comprehensiveness - services rendered; comprehensiveness - available services.Conclusions: the quality of performance self-reported by the professionals of the Family Health Strategy is not perceived or valued by clients, and the actions and services may have been developed inappropriately or insufficiently to be apprehended by the experience of clients.

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Estratégia saúde da família - a ótica dos cuidadores de crianças

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i3a24120p607-617-2018 ◽

2018 ◽

Vol 12 (3) ◽

pp. 607

Author(s):

Adriano Trigolo Pahim ◽

Maria Fernanda Pereira Gomes ◽

Lislaine Aparecida Fracolli

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Health ◽

Sao Paulo ◽

São Paulo ◽

Primary Health ◽

Health Strategy ◽

Care Assessment ◽

The Family ◽

Family Health Strategy

RESUMOObjetivo: avaliar sob a ótica dos cuidadores de crianças menores de dois anos e usuários adultos se os atributos essenciais e derivados da atenção primária à saúde estavam presentes e como estavam sendo operacionalizados na Estratégia Saúde da Família. Método: estudo quantitativo, descritivo e transversal realizado em três municípios da região de Presidente Prudente, Estado de São Paulo, Brasil. Utilizou-se o instrumento de avaliação da atenção primária à saúde (PCATool) na versão criança e adulto, em que 176 cuidadores de crianças menores de dois anos e 181 adultos usuários participaram da pesquisa. Resultados: os atributos da atenção primária à saúde estavam presentes na Estratégia Saúde da Família da região; porém, alguns atributos como Coordenação – Integração de Cuidados, Acesso de Primeiro Contato – Acessibilidade e Orientação Familiar precisavam melhorar sua operacionalização. Conclusão: os atributos da atenção primária à saúde devem estar adequadamente incorporados à prática dos profissionais da saúde por meio da capacitação e valorização das ações que caracterizam a Estratégia Saúde da Família como modelo com foco na família. Descritores: Avaliação em Saúde; Estratégia Saúde da Família; Atenção Primária à Saúde; Saúde Pública; Saúde da Criança; Saúde do Adulto. ABSTRACT Objective: to assess whether the essential attributes and derivatives of primary health care were present and how they were being implemented in the Family Health Strategy from the point of view of caregivers of children under two years of age and adult users. Method: quantitative, descriptive and cross-sectional study conducted in three municipalities of the region of Presidente Prudente, State of São Paulo, Brazil. We used the child and adult versions of the Primary Care Assessment Tool (PCATool), and 176 caregivers of children under two years of age and 181 adult users participated in the research. Results: the attributes of primary health care were present in the Family Health Strategy in the region; however, some attributes, such as healthcare coordination-integration, access to initial contact–accessibility, and family guidance needed to have their implementation improved. Conclusion: the attributes of primary health care should be properly incorporated into the practice of health professionals through training and actions that characterize the Family Health Strategy as a model with a focus on the family. Descritoprs: Health Assessment; Family Health Strategy; Primary Health Care; Public Health; Child Health; Adult Health. RESUMEN Objetivo: evaluar bajo la óptica de los cuidadores de niños menores de dos años y adultos usuarios si los atributos esenciales y derivados de la atención primaria de salud estaban presentes y cómo estaban siendo puestos en marcha en la Estrategia Salud de la Familia. Método: estudio cuantitativo, descriptivo y transversal realizado en tres municipios de la región de Presidente Prudente, Estado de São Paulo, Brasil. Se usaron las versiones niño y adulto del Instrumento de Evaluación de la Atención Primaria (PCATool) y 176 cuidadores de niños menores de dos años y 181 adultos participaron en la investigación. Resultados: los atributos de la atención primaria de salud estaban presentes en la Estrategia Salud de la Familia en la región; sin embargo, algunos atributos tales como coordinación-integración de los cuidados, acceso a primer contacto–accesibilidad y asesoramiento familiar necesitaban mejorar su puesta en marcha. Conclusión: los atributos de la atención primaria de salud deben ser debidamente incorporados a la práctica de profesionales de la salud a través de capacitación y desarrollo de acciones que caracterizan la Estrategia Salud de la Familia como un modelo con enfoque en la familia. Descriptores: Evaluación De La Salud; Estrategia Salud de la Familia; Atención Primaria de Salud; Salud Pública; Salud Del Niño; Salud del Adulto.

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Family and community guidance in adolescence: assessment in the family health strategy

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.4599.3457 ◽

2021 ◽

Vol 29 ◽

Author(s):

Rosimara Oliveira Queiroz ◽

Márcia Moroskoski ◽

Bianca Machado Cruz Shibukawa ◽

Roberta Tognollo Borotta Uema ◽

Rosana Rosseto de Oliveira ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Health ◽

Communication Process ◽

Care Practice ◽

Primary Health ◽

Health Strategy ◽

Care Assessment ◽

The Family ◽

Family Health Strategy

Objective: to evaluate family and community guidance in adolescence, within the scope of Primary Health Care. Method: an evaluative and descriptive study with a quantitative approach, developed through the application of the Primary Care Assessment Instrument (PCATool), with 70 professionals from the Family Health Strategy and 140 adolescents from the widerange areas. Data collection took place in Basic Health Units and in the adolescents’ homes in a municipality of southern Brazil, from May to September 2019. The data were analyzed using descriptive and inferential statistics using ANOVA and Tukey’s test, performed using the R Studio software. Results: there was divergence in the assessment of the attributes of family and community guidance between users and responsible professionals, showing weaknesses in the communication process and in the formation of the care bond in this reality, with impacts on quality of care. Conclusion: there was a need for continued assessment of the care practice in primary health care, as well as for permanent education with a focus on increasing qualification of care for adolescents.

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Home visits of the nurse and its relationship with hospitalization by diseases sensitive to primary health care

Escola Anna Nery ◽

10.1590/2177-9465-ean-2018-0285 ◽

2019 ◽

Vol 23 (2) ◽

Author(s):

Mayra Romélia Leite Garcia ◽

Daniel Souza Sacramento ◽

Hadelândia Milon de Oliveira ◽

Maria Jacirema Ferreira Gonçalves

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Health ◽

Home Visits ◽

Population Coverage ◽

High Coverage ◽

Primary Health ◽

Health Strategy ◽

The Family ◽

Family Health Strategy

Abstract Objective: To identify if nurses' home visits recorded by the family health strategy are proportional to the registered population and the population covered by the family health team, and its relationship with the rate of hospitalization for conditions sensitive to primary health care. Method: Secondary data were gathered from the Information Systems of Primary Care and Hospitalization regarding potential population coverage, number of visits done, hospitalizations for diseases sensitive to primary health care. An exploratory analysis was performed with data grouping for triennium (2010-2012 and 2013-2015) and assignment of scores for each variable, creating the classification strata in: low, medium and high. Results: It was identified that the number of registered home visits does not meet the estimated population coverage as well as does not impact on the admissions sensitive to primary health care. Conclusion and implications for practice: Even with high coverage of the family health strategy, home visits are not the main focus of nurses yet. Home visits should be used as a tool for disease prevention and health promotion, which may explain the non-reduction of hospitalizations sensitive to primary health care.

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Médicos de Família e Comunidade ou médicos da Estratégia Saúde da Família? / Family and Community doctors, or doctors from the Family Health strategy?

ID on line REVISTA DE PSICOLOGIA ◽

10.14295/idonline.v15i58.3028 ◽

2021 ◽

Vol 15 (58) ◽

pp. 242-244

Author(s):

Leonardo Ferreira Fontenelle

Keyword(s):

Mental Health ◽

Health Care ◽

Family Health ◽

Medical Specialty ◽

Scope Of Practice ◽

Primary Health ◽

Health Strategy ◽

The Family ◽

Family Health Strategy

Em resposta à revisão integrativa “Papel do Médico de Família e Comunidade no Manejo da Hipertensão Arterial na Atenção Primaria à Saúde”, cumpre destacar que os médicos de família e comunidade constituem uma especialidade médica, enquanto os médicos da estratégia Saúde da Família constituem uma ocupação. Discute-se a não sobreposição entre as duas categorias no mercado de trabalho, e a distinção no que diz respeito ao escopo da prática, com ênfase na saúde mental.---Abstract: In response to the integrative review “Role of the Family and Community Doctor in theManagement of Hypertension in Primary Health Care”, it should be noted that family and communitydoctors are a medical specialty, while doctors of the Family Health strategy constitute an occupation. Itdiscusses the non-overlapping between the two categories in the labor market, and the distinctionregarding the scope of practice, with an emphasis on mental health.

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Longitudinality in Primary Health Care: a comparison between care models

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2017-0014 ◽

2018 ◽

Vol 71 (3) ◽

pp. 1063-1071 ◽

Cited By ~ 6

Author(s):

Marciane Kessler ◽

Suzinara Beatriz Soares de Lima ◽

Teresinha Heck Weiller ◽

Luís Felipe Dias Lopes ◽

Lucimare Ferraz ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

Family Health ◽

Primary Health ◽

Regional Health Care ◽

Health Strategy ◽

Care Assessment ◽

The Family ◽

Family Health Strategy

ABSTRACT Objective: to evaluate the attribute longitudinality in different models of assistance in Primary Health Care and observe its association with demographic, socioeconomic and health care characteristics. Method: a cross-sectional study, carried out in 2015 with 1076 adult users of primary care services in the 32 cities of the 4th Regional Health Care Core of Rio Grande do Sul State. The Primary Care Assessment Tool was used with definition of low (<6.6) or high (≥6.6) score for longitudinality. The association with independent variables was observed through the Poisson regression. Results: the attribute was better assessed in the Family Health Strategy and associate with age, housing health region and care model. Conclusion: the study points out the Family Health Strategy as a promoter of longitudinal care, and so, it suggests the expansion of this assistance model coverage for quality improvement in health care.

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Oral health indicators in primary health care: the understanding and the information recorded by dentist-surgeons

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-8637201400010000062505 ◽

2014 ◽

Vol 62 (1) ◽

pp. 37-45

Author(s):

Patrícia Maria Costa de OLIVEIRA ◽

Léa Maria Bezerra de MENEZES ◽

Maria Vieira de Lima SAINTRAIN ◽

Paulo César de ALMEIDA ◽

Maria Eneide Leitão de ALMEIDA

Keyword(s):

Health Care ◽

Oral Health ◽

Sampling Error ◽

Family Health ◽

Health Indicators ◽

Ministry Of Health ◽

Health Strategy ◽

The Family ◽

Family Health Strategy ◽

Oral Health Indicators

OBJECTIVE: This study aimed to know the understanding of Oral health indicators recommended by the Ministry of Health by dentists in the family health strategy of the state of Ceará in 2008. METHODS: It is a descriptive, cross-sectional study in which it was used a questionnaire to obtain the data concerning the way information on oral health actions performed in Family Health Care Units and other social spaces are registered, as well as investigate their knowledge about oral health indicators. The calculation of the sample of dentist-surgeons adopted an absolute sampling error of 6.8% and a significance level of 5%, resulting in an initial sample of 175 dentists; however, only 159 participated in this study according to the inclusion criteria. For instance, they should have been working in the service in the period from 2001 to 2007. In all, 32 cities participated in the research, distributed in 18 Regional Health Cells selected by drawing lots. The data were processed in the program SPSS version 17.0 and considered statistically significant the inferential analyses with p < 0.05. RESULTS: it was observed that there are differences between the interpretation of the indicators objectives and the data relating to oral health actions recorded by dentist-surgeons from the Family Health Strategy. They also differ from the guidelines of the Ministry of Health. CONCLUSION: The pregnant present some knowledge about oral health that can be improved by means of educational, preventive and healing programs. This group exert big it influences in the family ambit, could act as agents multipliers and avoiding the child's precocious contamination.

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