Children's health care assistance according to their families: a
               comparison between models of Primary Care

Oliveira, Vanessa Bertoglio Comassetto Antunes de; Veríssimo, Maria de La Ó Ramallo

doi:10.1590/S0080-623420150000100004

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Artigo Original • Rev. esc. enferm. USP 49 (01) • Jan-Feb 2015 • https://doi.org/10.1590/S0080-623420150000100004 copy

Children's health care assistance according to their families: a comparison between models of Primary Care^* * Extracted from the thesis "Evaluation of Primary Child Health in the municipality of Colombo- Paraná," Graduate Program in Nursing, School of Nursing, University of São Paulo, 2012.

Asistencia a la salud del niño según sus familias: comparación entre modelos de Atención Primaria

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE

To compare the health assistance models of Basic Traditional Units (UBS) with the Family Health Strategy (ESF) units for presence and extent of attributes of Primary Health Care (APS), specifically in the care of children.

METHOD

A cross-sectional study of a quantitative approach with families of children attended by the Public Health Service of Colombo, Paraná. The Primary Care Assessment Tool (PCA-Tool) was applied to parents of 482 children, 235 ESF units and 247 UBS units covering all primary care units of the municipality, between June and July 2012. The results were analyzed according to the PCA-Tool manual.

RESULTS

ESF units reached a borderline overall score for primary health care standards. However, they fared better in their attributes of Affiliation, Integration of care coordination, Comprehensiveness, Family Centeredness and Accessibility of use, while the attributes of Community Guidance/Orientation, Coordination of Information Systems, Longitudinality and Access attributes were rated as insufficient for APS. UBS units had low scores on all attributes.

CONCLUSION

The ESF units are closer to the principles of APS (Primary Health Care), but there is need to review actions of child care aimed at the attributes of APS in both care models, corroborating similar studies from other regions of Brazil.

Child; Primary Health Care; Health Evaluation; Child Health; Family Health Strategy

Indicador	ESF		UBS		T Test
	(n=235)		(n=247)
	Score	Ep	Score	Ep
First contact access - Usage
You go to your healthcare provider before going to another for a routine appointment	7,3	0,18	5	0,18	<0,001^* * Statistically significant values
You go to your healthcare provider before you go to another for a new problem	7,6	0,149	4,7	0,16	< 0,01^* * Statistically significant values
Your health service sends you to a specialist when necessary	7	0,188	7,6	0,16	0,020006^* * Statistically significant values
First contact access - Accessibility
The health service attends you in the same day	6,4	0,187	4,3	0,17	< 0,0001^* * Statistically significant values
There is a long wait to schedule an appointment	4,7	0,209	1,8	0,13	< 0,0001^* * Statistically significant values
It's easy to make an appointment for a routine checkup for a child	5,9	0,182	3,2	0,14	< 0,0001^* * Statistically significant values
You have to wait more than 30 minutes for an appointment	3,7	0,175	1,2	0,11	< 0,0001^* * Statistically significant values
It's difficult to get medical attention in the service	6,2	0,161	2,6	0,16	< 0,01^* * Statistically significant values
You have been able to get information over the phone in the service	3,9	0,176	2,7	0,13	< 0,0001^* * Statistically significant values
Longitudinality
It's the same professional that attends my child in the service	7	0,166	2,8	0,14	< 0,01^* * Statistically significant values
You can call to speak to the professional in the service	3,7	0,148	2,6	0,14	< 0,0001^* * Statistically significant values
The professional understands what you say or ask	7,3	0,153	4,3	0,15	< 0,01^* * Statistically significant values
The professional answers your questions in a way that you can understand	4,6	0,159	4,1	0,16	0,018601^* * Statistically significant values
You feel comfortable to talk to the professional about your child's problems	5,7	0,188	5,4	0,18	0,195223
The professional gives you enough time to talk about your problems or concerns	3,6	0,165	2,3	0,14	< 0,0001^* * Statistically significant values
The professional recognizes the child as a person and more than just a health problem	4,5	0,19	3,1	0,15	< 0,0001^* * Statistically significant values
The professional knows the health/clinical history of the child	5,2	0,193	2,7	0,14	< 0,0001^* * Statistically significant values
The professional knows the medication that the child takes	5,9	0,178	4,4	0,17	< 0,0001^* * Statistically significant values
The professional will meet with the family if necessary	6	0,175	2,9	0,14	< 0,01^* * Statistically significant values
You would move to another health service if it were easy	5,7	0,192	2,4	0,13	< 0,01^* * Statistically significant values
Coordination / Integration of Care
The professional of your service knows of your appointment with a specialist	8,1	0,11	5,3	0,14	0,001156^* * Statistically significant values
The professional of your service knew the results of your appointment with the specialist	7,7	0,104	6	0,16	0,063386^* * Statistically significant values
Your service recommended a specialist for you	7,9	0,13	7	0,12	0,252483
After your appointment with the specialist, the professional of your service spoke with you	6,3	0,16	5	0,15	0,176225
The professional of your service expressed an interest in your appointment with the specialist	7,7	0,163	5,7	0,14	0,038722^* * Statistically significant values
Coordination - Information Systems
You take your vaccination record to your appointments	7,4	0,118	6,1	0,16	< 0,0001^* * Statistically significant values
The medical records of the child are always available in consultations/appointments	5,8	0,168	5,2	0,17	0,007427^* * Statistically significant values
You have access to the child's medical records	5,7	0,177	4,2	0,16	< 0,0001^* * Statistically significant values
Comprehensiveness of Available Services
Social Assistance Program	6,4	0,15	4,1	0,17	< 0,0001^* * Statistically significant values
Family Planning	7,2	0,146	4,9	0,17	< 0,0001^* * Statistically significant values
Supplemental nutrition program	5,4	0,18	4,6	0,16	0,003841^* * Statistically significant values
Drug use counseling	4,6	0,177	3,4	0,13	< 0,0001^* * Statistically significant values
Vaccines	8,2	0,116	8,4	0,11	0,357689
Counseling for mental health problems	5,2	0,167	3,5	0,14	< 0,0001^* * Statistically significant values
Suturing/stitching	7,4	0,158	5,5	0,15	< 0,0001^* * Statistically significant values
STD Counseling and HIV testing	5	0,182	4	0,17	0,000296^* * Statistically significant values
Eye and vision health testing	6	0,174	4	0,15	< 0,0001^* * Statistically significant values
Family Centeredness
The professional knows your family well enough	6	0,132	3,3	0,14	< 0,01^* * Statistically significant values
The professional knows the main problems in your family	5,9	0,209	3,2	0,14	< 0,0001^* * Statistically significant values
The professional knows the employment of the child's parents/guardians	5,3	0,151	2,4	0,14	< 0,01^* * Statistically significant values
The professional would know the problems of family to get medications	5,3	0,153	2,6	0,14	< 0,01^* * Statistically significant values
The professional asks your opinion about the child's treatment	6,1	0,16	4,5	0,18	< 0,001^* * Statistically significant values
The professional knows the health problems/medical history of the family	6,9	0,148	4,8	0,18	< 0,001^* * Statistically significant values
Community Orientation
Someone from your health service makes home visits	7,6	0,143	1,2	0,1	< 0,01^* * Statistically significant values
Your health service knows the neighborhood health problems	5,8	0,162	2,7	0,13	< 0,01^* * Statistically significant values
Your health service does research in the community to identify problems	5,4	0,175	1,4	0,1	< 0,01^* * Statistically significant values
Your health service invites family members to participate in Health Counselling	3,6	0,155	1,9	0,12	< 0,0001^* * Statistically significant values

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Correspondence: Vanessa Bertoglio Comassetto Antunes de Oliveira. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira Cesar, CEP 05403-000 - São Paulo, SP, Brasil. vcomassetto@usp.br

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Children's health care assistance according to their families: a comparison between models of Primary Care* * Extracted from the thesis "Evaluation of Primary Child Health in the municipality of Colombo- Paraná," Graduate Program in Nursing, School of Nursing, University of São Paulo, 2012.

Asistencia a la salud del niño según sus familias: comparación entre modelos de Atención Primaria

OBJECTIVE

METHOD

RESULTS

CONCLUSION

Children's health care assistance according to their families: a comparison between models of Primary Care^* * Extracted from the thesis "Evaluation of Primary Child Health in the municipality of Colombo- Paraná," Graduate Program in Nursing, School of Nursing, University of São Paulo, 2012.