Assessment of Primary Health Care Attributes in Campina Grande, Paraíba, Brazil

this is a cross-sectional study with 202 professionals from the Basic Health Units. The Primary Care Assessment Tool, Brazil, was used, which includes eight attributes of primary care whose scores were converted into a scale from 0 to 10, with those considered satisfactory > 6.60.

Result:

the general score mean was 7.6, but First contact access obtained a score of 3.7. Dental surgeons attributed the worst scores for all attributes (p <0.05). Permanent education activity was associated with a high general score (p <0.01).

Conclusion:

with the exception of First contact access, the other attributes are present, but initiatives by teams and managers are necessary for its expansion, with permanent education being the main strategy in this process.

Descriptors:
Public Health; Primary Healthcare; Health Services Research; Health Personnel; Public Health Professional

Variable	Low General Score		High General Score		p^ Note:*
Variable	n	%	n	%	p^ Note:*
Sex
Male	7	12.30	22	15.20	0.5978
Female	50	87.70	123	84.80
Age
> 40 years old	32	56.10	68	46.90	0.2369
≤ 40 years old	25	43.90	77	53.10
Category
Nurse	18	31.60	70	48.30	< 0.01
Doctor	17	29.80	53	36.60
Dental surgeon	22	38.60	22	15.20
Institution
Public	44	77.20	101	69.70	0.284
Private	13	22.80	44	30.30
Time passed after graduation
≥ 16 years	34	59.60	65	44.80	0.0578
< 16 years	23	40.40	80	55.20
Work location
Urban	53	93.00	128	88.30	0.733
Mixed	2	3.50	7	4.80
Rural	2	3.50	10	6.90
Graduate
Yes	41	71.90	115	79.30	0.2602
No	16	28.10	30	20.70
Type of graduate
Specialization	34	59.60	85	58.60	0.6419
Master's degree	3	5.30	14	9.70
Doctoral degree	0	0.00	2	1.40
Residency	4	7.00	14	9.60
None	16	28.10	30	20.70
Permanent education
Yes	36	63.20	119	82.10	< 0.01
No	21	36.80	26	17.90
Length of work at PHC
≥ 14 years	29	50.90	68	46.90	0.6102
< 14 years	28	49.10	77	53.10
Team length
≥ 4 years	29	50.90	71	49.00	0.8067
< 4 years	28	49.10	74	51.00
Employment relationship
Statutory	30	52.60	73	50.30	0.5125
Contract	23	40.40	51	35.20
Residency	2	3.50	7	4.80
Scholarship holder	2	3.50	14	9.70
Workload
< 40 hours	2	3.50	9	6.20	0.5509
>40 hours	55	96.40	136	93.80
Municipal incentive
Yes	26	45.60	69	47.60	0.5685
No	25	43.90	54	37.20
Not sure	6	10.50	22	15.20

Primary Health Care Attributes	Minimum	Maximum	Mean^† † Symmetric distribution; /Median^* * Asymmetric distribution; SD - Standard Deviation.	SD
First contact access^* * Asymmetric distribution; SD - Standard Deviation.	1.48	6.67	3.70	1.12
Longitudinality^* * Asymmetric distribution; SD - Standard Deviation.	4.87	10.00	7.39	1.17
Coordination - integration of care^* * Asymmetric distribution; SD - Standard Deviation.	3.89	10.00	7.22	1.34
Coordination - information systems^* * Asymmetric distribution; SD - Standard Deviation.	3.33	10.00	8.88	1.53
Comprehensiveness - services available^† † Symmetric distribution;	2.73	10.00	6.96	1.20
Comprehensiveness - services provided^* * Asymmetric distribution; SD - Standard Deviation.	0.22	10.00	7.88	1.86
Family orientation^* * Asymmetric distribution; SD - Standard Deviation.	3.33	10.00	8.88	1.62
Community orientation^* * Asymmetric distribution; SD - Standard Deviation.	2.78	10.00	7.22	1.66
Essential Score^† † Symmetric distribution;	4.69	9.30	6.89	0.89
Variate Score^† † Symmetric distribution;	3.33	10.00	7.77	1.36
General Score^† † Symmetric distribution;	4.77	9.72	7.16	0.98

Primary Health Care Attributes	Dental Surgeon		Nurse		Doctor
Primary Health Care Attributes	Mean^* * Student's t test for variables with normal distribution (mean); /Median^† † Man-Whitney test for variables with abnormal distribution (median); a - without statistically significant difference; b- statistically significant difference (p <0.05).	(95% CI)/II	Mean^* * Student's t test for variables with normal distribution (mean); /Median^† † Man-Whitney test for variables with abnormal distribution (median); a - without statistically significant difference; b- statistically significant difference (p <0.05).	(95% CI)/II	Mean^* * Student's t test for variables with normal distribution (mean); /Median^† † Man-Whitney test for variables with abnormal distribution (median); a - without statistically significant difference; b- statistically significant difference (p <0.05).	(95% CI)/II
Accessibility^† † Man-Whitney test for variables with abnormal distribution (median); a - without statistically significant difference; b- statistically significant difference (p <0.05).	3.33a	2.96 - 4.53	3.70a	2.96 - 4.44	3.88a	2.96 - 4.72
Longitudinality^* * Student's t test for variables with normal distribution (mean);	7.00b	6.67 - 7.33	7.55a	7.32 - 7.79	7.48a	7.18 - 7.78
Coordination - integration of care^* * Student's t test for variables with normal distribution (mean);	6.99a	6.57 - 7.41	7.22a	6.93 - 7.52	7.14a	6.84 - 7.45
Coordination - information systems^† † Man-Whitney test for variables with abnormal distribution (median); a - without statistically significant difference; b- statistically significant difference (p <0.05).	7.78b	6.67 - 8.89	8.89a	7.78 - 10.0	8.89a	7.78 - 10.0
Comprehensiveness - services available*	7.16a	6.81 - 7.50	6.89a	6.61 - 7.17	6.94a	6.68-7.20
Comprehensiveness - services provided^† † Man-Whitney test for variables with abnormal distribution (median); a - without statistically significant difference; b- statistically significant difference (p <0.05).	5.55b	4.61 - 7.11	8.22a	7.33 - 9.11	8.33a	7.11 - 9.11
Family orientation^† † Man-Whitney test for variables with abnormal distribution (median); a - without statistically significant difference; b- statistically significant difference (p <0.05).	8.34b	6.67 - 8.89	8.89a	7.78 - 10.0	9.45a	7.78 - 10.0
Community orientation^* * Student's t test for variables with normal distribution (mean);	6.77a	6.15 - 7.38	7.38a	7.07 - 7.69	7.17a	6.78 - 7.57
Essential Score^* * Student's t test for variables with normal distribution (mean);	6.32b	6.08 - 6.57	7.06a	6.87 - 7.24	7.05a	6.85 - 7.25
Variate Score^* * Student's t test for variables with normal distribution (mean);	6.56b	6.27 - 6.85	7.29a	7.11; 7.48	7.28a	7.07 - 7.48
General Score^* * Student's t test for variables with normal distribution (mean);	7.26b	6.75 - 7.77	8.00a	7.74 - 8.26	7.95a	7.65 - 8.26

Variable	High General Score
Variable	cPR^* * cPR - Crude Poisson Regression; /(95% CI)	adjPR^† † adjPR: Adjusted Poisson Regression by: category, time passed after graduation, permanent education, employment relationship and municipal incentive; CI - Confidence Interval; PMM - Programa Mais Médicos (More Doctors Program). /(95% CI)	P (Wald's test)	P (LR-test)
Category				0.035
Doctor	1.51 (0.92-2.49)	1.22 (1.01-1.49)	0.042
Nurse	1.59 (1.01-2.57)	1.33 (1.08-1.63)	0.029
Dental surgeon	1	1
Time passed after graduation				0.576
<16 years	1.18 (0.85-1.64)		0.576
>16 years	1	1
Permanent education				0.046
Yes	1.39 (0.91-2.12)	1.35 (1.03-1.76)	0.047
No	1	1
Employment relationship				0.965
Statutory	1.03 (0.72-1.47)	1.05 (0.67-1.64)	0.965
Scholarship holder (PMM)	1.27 (0.71-2.29)	1.18 (0.61-2.26)	0.625
Resident	1.13 (0.51-2.48)	0.99 (0.42-2.33)	0.992
Hired	1
Municipal incentive				0.781
Yes	1.06 (0.74-1.52)	0.99 (0.68-1.43)	0.937
Not sure	1.15 (0.7-1.89)	1.17 (0.7-1.96)	0.539
No	1	1

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[1] Corresponding author: Rafaela Simão de Abrantes. E-mail: rafaelaabrantes19@gmail.com