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Evaluation of primary health care: comparison between organizational models

Abstract

Primary Health Care (APS) refers to a set of practices that aims to meet the health needs of the individual and the community. At this level of care, certain attributes must be developed to ensure the quality of services: First Contact, Longitudinality Integrality, Coordination, Family Focus, Community Orientation, and Cultural Competence. The objective of this study was to identify, evaluate, and compare the attributes of Primary Health Care considering two organizational models. We did an exploratory, cross-descriptive research, applying the Primary Care Assessment Tool Brazil Instrument, professional version, to 70 doctors and 33 nurses working in primary care in a city in the state of São Paulo, Brazil. Descriptive and inferential statistics were used. Traditional primary care showed average scores above 6.6 in the attributes of coordination, longitudinality, comprehensiveness – services provided and family guidance. The attributes that received a low score were comprehensiveness – available services, community guidance, and first contact access, the latter being the only attribute with an average score below 6.6 in the Family Health Strategy. A difference was identified between the models, with better results in the Family Health Strategy compared to traditional primary care, in the essential, derived and general scores. It was concluded that the Family Health Strategy presented better results in the evaluated attributes, representing greater quality. Therefore, the expansion of coverage by this model is presented as a strategy to strengthen this level of assistance. The applicability of the study arises from the strategic sharing of results for professionals and managers, aiming at the joint construction of coping guidelines: awareness of the priority agenda for APS, insertion of the Reflection of the Practice as a Permanent Education tool for the teams, strengthening of the Regional Health (DRS) partnership with the university.

Keywords
Primary Health Care; evaluation of health services; Family Health Strategy

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