Use of Information Technology in evaluation of access and quality Primary Health Care in Brazil: qualitative study (Preprint)

2021 ◽  
Author(s):  
Osvaldo de Goes Bay Junior ◽  
Cícera Renata Diniz Vieira Silva ◽  
Cláudia S Martiniano ◽  
Monique da Silva Lopes ◽  
Lygia Maria de Figueiredo Melo ◽  
...  
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Primary Health Care ◽  
Data Collection ◽  
Quality Standards ◽  
Data Consistency ◽  
Health Policies ◽  
Quality Data ◽  
Primary Health ◽  
Access And Quality

BACKGROUND The increased applicability of information technology for evaluating health policies, programs, and care requires advancements in understanding trends, influences, its use by evaluators, and the implications for quality standards of evaluation. OBJECTIVE This study aimed to assess the applicability of information technology in evaluation the Access and quality of primary health care in Brazil considering international quality standards. METHODS We conducted a qualitative case study during the External Evaluation of Brazil’s National Program for Improving Primary Care Access and Quality. Data collection consisted of interviews, focus groups, and document analysis. Seven technicians from the Ministry of Health and 47 researchers from various high education and research institutions across the country participated in the study. Data were categorized using the software Atlas.ti, according to the quality standards of the Joint Committee on Standards for Education Evaluation, followed by Bardin’s content analysis. RESULTS Results related to feasibility, thematic scope, field activity management, standardized data collection, data consistency, and transparency, demonstrate improvements and opportunities for advancements in evaluation mediated by the use of Information Technology, favoring the emergence of new practices and remodeling of existing ones, taking into account the multiple components required by the complex assessment of access and quality in primary health care. Difficulty in operating, inoperative system, and lack of investment in equipment and human resources are challenges to increase the effectiveness of information technology in evaluation. CONCLUSIONS The strategic and intelligent use of information technology offered evaluators a greater opportunity to stakeholder engagement, to insert different organizational, operational, and methodological components, capable of triggering influences and confluences, with connections in collaborative and synergistic networks to increase the quality and allow the development of a more consistent and efficient evaluation with greater possibility of incorporating the results into public health policies.

scholarly journals Social determinants of depression: association with age, gender and primary health care model

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J China
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Social Determinants ◽  
Care Physician ◽  
Health Policies ◽  
Age And Gender ◽  
Primary Health ◽  
And Gender ◽  
Primary Health Care Physician

Abstract Background Depression is one of the most common mental disorders worldwide and is a major contributor to the overall global burden of disease. The social determinants of age, gender and access to a primary health care physician have been identified as significant determinants of variability in the prevalence of depression. This research evaluates the association between depression and these social determinants in the city of Almada, in Portugal. Methods This cross-sectional study reports the one-month prevalence (December, 2015) of depression and its association with age, gender and access to a primary health care doctor in Almada's primary health care population. Data was collected from the 'Information System of the Regional Health Administration' (SIARS) database. The diagnostic tools used for the identification of cases were the ICPC-2 codes 'P76: Depressive Disorder' and 'P03: Feeling Depressed'. An odds ratio was applied as an association measure. Results Regarding gender and age: women are more likely to develop depression than men (OR 3.21) and the age group of 40-64 years is more likely to develop depression compared with other age groups (OR 2.21). The odds of being affected by depression for patients with a permanent primary health care physician, compared with users without a permanent primary health care physician, are higher (OR 2.24). Conclusions The patterns of association of age and gender, uncovered in this dataset, are consistent with previously reported findings for other Western countries. The association between depression and the assignment of a permanent primary health care doctor is highly significant. This finding suggests the existence of a higher detection rate of depression in patients with a permanent doctor and adds weight to the need to implement health policies that guarantee a primary health care physician for each patient. Key messages The age and gender gap in depression calls for stronger public health and intersectoral strategies to promote and protect mental health, in community-based settings. Reducing barriers and enhancing access to high-quality primary medical care must be a cornerstone of mental health policies.

Brazilian National Household Health Survey and PCAT: the case of Mato Grosso do Sul, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L F Pinto ◽  
D Soranz ◽  
L J Santos ◽  
M S Paranhos ◽  
L S Malta ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Health Survey ◽  
Household Surveys ◽  
Mato Grosso ◽  
Primary Health ◽  
The World ◽  
Mato Grosso Do Sul

Abstract Brazil is divided into five administrative regions, 27 federation units and 5,570 municipalities. Mato Grosso do Sul is one of the states located in the Midwest region and has 1.6 million km2 and a resident population of 2.8 million inhabitants, that is, it has an even lower demographic density than its region - only 7.8 inhabitants/km2. Mato Grosso do Sul has part of the Pantanal, a biome considered the largest continuous floodplain in the world, rich in biodiversity. For this reason, displacements for data collection in household surveys combine roads and rivers. In 2019, the Brazilian National Institute of Geography and Statistics (Istituto Nazionale di Statistica del Brasile) in partnership with the Ministry of Health launched the world's largest household sample survey, the National Health Survey (PNS-2019), in which part of its questions included the use of Primary Care Assessment Tool (PCAT, adult version), created by professors Barbara Starfield and Leiyu Shi in the 2000s. IBGE interviewers visited more than 100,000 households across the country. In Mato Grosso do Sul, more than 3,000 households were surveyed. In this work, we present the data collection instrument used by IBGE and its multiple analysis possibilities in the scope of primary health care, crossing the variables from other questionnaire modules in order to compare the results from Brazil with the state of Mato Grosso do Sul and its capital, Campo Grande. Developing a baseline and measuring the attributes of primary health care in each of the Brazilian states is another step towards giving health policy accountability, towards strong primary care. IBGE's experience in household surveys and innovation in data collection in primary care is an example for the world that yes, it is possible to develop statistically representative national sample surveys and make them perennial in their regular household surveys, by the time World Health Organization (WHO) discusses universal health coverage. Key messages Evaluation of primary care using an internationally validated instrument is possible on national bases with random household sample surveys. A questionnaire elaborated academically can be used as an instrument of public policy to evaluate nationwide health services.

scholarly journals Quality of Primary Health Care in Brazil: patients'view

2018 ◽  
Vol 71 (suppl 6) ◽  
pp. 2713-2719
Author(s):  
Daniela Cristina Moreira Marculino de Figueiredo ◽  
Helena Eri Shimizu ◽  
Walter Massa Ramalho ◽  
Alexandre Medeiros de Figueiredo ◽  
Kerle Dayana Tavares de Lucena
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Clinical History ◽  
Coordination Of Care ◽  
Primary Health ◽  
Comprehensive Health ◽  
Access And Quality ◽  
Transversal Study

ABSTRACT Objective: To describe the evaluation of patients that participated in the National Program for Improving the Access and Quality in Primary Health Care (Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica) for the comprehensive healthcare, the bond and the coordination of care in the country's macro-regions. Method: A descriptive, transversal study, from interviews with 65,391 patients of Primary Health Care, in 3,944 municipalities regarding the use of health services. Results: The professionals seek to solve the patients' problems in their unit (73.1%) but focused mainly on the scope of the appointment (65.6%) and offering care away from the population's reality (69.4%). Difficulties in the rescue of clinical history were referred (50.3%) and in the care performed in other health services (29.2%). Conclusion: The comprehensive health care, the bond and the coordination of care remain challenges to the Primary Health Care in the country, requiring reflections on the implementation of national policies, especially considering the regional diversities in Brazil.

scholarly journals Maternal mode of living and child health

2002 ◽  
Vol 55 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Jane L.G. Dytz ◽  
Semíramis M. M. Rocha
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Low Income ◽  
Reproductive Behavior ◽  
Federal District ◽  
Health Policies ◽  
Socioeconomic Conditions ◽  
Primary Health ◽  
Mothers And Children ◽  
And Child Health

ln this article, maternal mode of living is investigated, examining both socioeconomic conditions and lifestyle factors, in order to identify to what extent health policies are tangibly meeting the needs of low income Brazilian mothers and children. Data are derived from unstructured interviews with 17 mothers with children underage 6, residing in the Federal District, Brazil. Their stories reveal a life marked by economic difficulties and inadequate living conditions, aggravated by early reproductive behavior, confinement to the home and no leisure. Although they have access to primary health care, the quality is inadequate. Increased awareness to the mother's situation is necessary in order to improve the health of young children.

Neoliberal Reforms in Swedish Primary Health Care: For Whom and for What Purpose?

2008 ◽  
Vol 38 (4) ◽  
pp. 697-715 ◽  
Author(s):  
Göran Dahlgren
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Low Income ◽  
Health Sector ◽  
High Income ◽  
Public Hospitals ◽  
Primary Health ◽  
Access And Quality

The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as “free choice models” in which “the money follows the patient.” The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.

scholarly journals Utilization of Breast Cancer Screening in Brazil: An External Assessment of Primary Health Care Access and Quality Improvement Program

2018 ◽  
Vol 4 (1) ◽  
pp. 42-55 ◽  
Author(s):  
Mara Rejane Barroso Barcelos ◽  
Bruno Pereira Nunes ◽  
Suele Manjourany Silva Duro ◽  
Elaine Tomasi ◽  
Rita de Cássia Duarte Lima ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Quality Improvement ◽  
Primary Health Care ◽  
Health Care Access ◽  
Improvement Program ◽  
External Assessment ◽  
Care Access ◽  
Primary Health ◽  
Access And Quality

scholarly journals Validation of the comprehensiveness of an instrument on ethical problems in primary care

2014 ◽  
Vol 35 (1) ◽  
pp. 148-156 ◽  
Author(s):  
José Roque JUNGES ◽  
Elma Lourdes Campos Pavone Zóboli ◽  
Rafaela SCHAEFER ◽  
Carlise Rigon Dalla NORA ◽  
Mikaela BASSO
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Ethical Problem ◽  
Ethical Problems ◽  
Methodological Research ◽  
Primary Health ◽  
Initial Stage

The study aimed to validate the comprehensiveness of an instrument on the occurrence of ethical problems in primary health care and discuss their results. This is a methodological research. The technique used was Delphi, which seeks to obtain a consensus on a subject by experts, using structured questionnaires that are modified to obtain consensus on the comprehensibility of content. The sample was composed by nine professionals with expertise in primary health care in São Leopoldo. Data collection was in March and April 2011. In the first round, the professional was asked to respond whether the described situation has represented an ethical problem, whether the statement was clear and whether there was any suggestion to rewriting the problem. Were presented thirty-six statements, and to twenty was suggested new rewrite. After the review and systematization the proposed amendments, has begun the second round to seek consensus among all the statements that its writing had changed. In the second round, the consensus required by the method was obtained. Using the method supported significantly to build the instrument in its initial stage, what makes it appropriated and comprehensive for the subsequent steps of the validation.

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