Accessibility to the treatment of hypertension in the family health strategy

Cross-sectional study, conducted with 417 people living in a city in the state of Paraná, Brazil. The data collection was performed between February and June of 2016, using a satisfaction instrument regarding the services provided by the Primary Health Care, using issues related to treatment accessibility. A descriptive and inferential analysis to treat the variables was adopted.

RESULTS

417 people participated in the study, from which 62.4% were elderly, 67.8% were female and 55.2% were retired/pensioners. The economic accessibility was the best evaluated indicator. The regular evaluation of the services characteristic of the geographical and organizational accessibility was significantly associated to the inadequate monitoring of these users in the Family Health Strategy.

CONCLUSION

The services offered to people with arterial hypertension were evaluated as regular, presenting the main barriers related to geographical and organizational aspects.

Keywords:
Primary Health Care; Health services research; Nursing; Family Health Strategy; Adult health; Hypertension

	N (%)
Age Group
20 - 29	15 (3.6)
30 - 39	25 (6.0)
40 - 49	37 (8.9)
50 - 59	80 (19.2)
60 - 69	127 (30.5)
≥ 70	133 (31.9)

Gender
Male	134 (32.1)
Female	283 (67.9)

Education level
No Education	32 (7.7)
Elementary school	255 (61.1)
High school	107 (25.7)
Higher education	23 (5.5)

Race/Color
White	260 (62.3)
Black	65 (15.6)
Brown	92 (22.1)

Monitoring in FHS (2015)
Adequate	262 (62.8)
Inadequate	155 (37.2)

Pressure Control
Adequate	224 (53.7)
Inadequate	193 (46.3)

Economy Class
AB	148 (35.5)
C	183 (43.9)
DE	86 (20.6)

Accessibility	Mean	SD	CI 95%
Geographic
When you go to the BHU for a consultation about your HBP problem, do you need to use some type of motorized transport?	3.86	1.48	3.72 - 4.01
Are you treating the HBP at the nearest health service from your home?	4.29	1.14	4.18 - 4.40
Do you have difficulty to move to the BHU to be consulted?	4.00	1.40	3.86 - 4.13
Composite Index	4.05	1.34	3.72 - 4.13
Economic
When you go to the BHU for a consultation about your HBP problem, do you miss your work shift or another appointment?	4.32	1.31	4.19 - 4.44
When you go to the BHU for a consultation, do you pay for the transport?	4.04	1.39	3.91 - 4.18
Composite Index	4.18	1.35	3.91 - 4.44
Organizational
If feel bad due to the medication or HBP, can you schedule a consultation within 24 hours at the BHU where you are being treated?	4.05	1.27	3.92 - 4.17
Do the BHU professionals who follow up your HBP treatment usually visit you in your home?	3.72	1.39	3.59 - 3.83
From when you started your treatment for HBP, did you stay without the medication?	4.56	0.95	4.47 - 4.66
When you go to the BHU for the consultation, does it take more than 60 minutes to be attended?	3.76	1.51	3.61 - 3.90
Can you carry out the exams requested by the health care professional who follow up your treatment?	4.29	1.18	4.17 - 4.40
Can you receive the results of the exams requested by the health care professional that follows up your treatment within 10 days?	4.12	1.23	4.00 - 4.24
Can you find a professional at the BHU to attend you on every working day of the week?	4.14	1.21	4.02 - 4.26
Is your return consultation scheduled?	3.78	1.40	3.65 - 3.92
Composite Index	4.05	1.10	3.59 - 4.66

	Total	Monitoring		Univariate Analysis			Multivariate Analysis
	N (%)	Adequate	Inadequate	OD	IC 95%	P	OD	IC 95%	P
Organizational Accessibility
Satisfactory	269 (64,5)	179	90	1			1
Unsatisfactory	29 (7,0)	19	10	1,04	0,46-2,34	0,912	1,08	0,46-2,48	0,856
Regular	119 (28,5)	64	55	1,70	1,10-2,65	0,017*	1,96	1,23-3,10	0,004
Economic Accessibility
Satisfactory	259 (62,1)	154	105	1
Unsatisfactory	61 (14,7)	37	24	0,97	0,50-1,89	0,95
Regular	97 (23,2)	71	26	0,86	0,48-1,54	0,629
Geographic Accessibility
Satisfactory	313 (75,1)	195	118	1			1
Unsatisfactory	43 (10,2)	27	16	0,95	0,53-1,98	0,864	0,97	0,48-1,58	0,656
Regular	61 (14,7)	40	21	1,53	1,32-2,89	0,019^* * p < 0,20;	1,46	1,27-1,78	0,014
Composite Accessibility
Satisfactory	268 (64,3)	164	104	1
Unsatisfactory	44 (10,6)	28	16	0,9	0,46-1,74	0,758
Regular	105 (25,2)	70	35	0,78	0,49-1,26	0,326
Pressure Control
Adequate	224 (53,7)	139	85	1
Inadequate^┼ ┼ PAS ≤ a 140 mmHg e PAD ≥ a 90mmHg;	193 (46,3)	123	70	0,93	0,62-1,38	0,931

Universidade Federal do Rio Grande do Sul. Escola de Enfermagem Rua São Manoel, 963 -Campus da Saúde , 90.620-110 - Porto Alegre - RS - Brasil, Fone: (55 51) 3308-5242 / Fax: (55 51) 3308-5436 - Porto Alegre - RS - Brazil
E-mail: revista@enf.ufrgs.br

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[1] Corresponding author:
Anderson da Silva Rêgo. anderson.dsre@hotmail.com