Evaluation of Primary Health Care: validation of an instrument to analyze the performance of services

Cubas, Marcia Regina; Faoro, Nilza Teresinha; Moysés, Simone Tetu; Carvalho, Deborah Ribeiro

doi:10.1590/0103-1104201711310

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ORIGINAL ARTICLE • Saúde debate 41 (113) • Apr-Jun 2017 • https://doi.org/10.1590/0103-1104201711310 copy

Evaluation of Primary Health Care: validation of an instrument to analyze the performance of services

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

This article has been originated in a research that aimed to identify and validate the relevance of the indicators present in an instrument of evaluation of Primary Health Care. Sixty experts evaluated 23 indicators of the dimensions 'user as the center of the process', 'organization of processes focused on users', 'link, competencies, skills and professional attitudes' and 'organizational ambience'. Four indicators obtained a maximum Content Validity Index (CVI): 'research with users of health services', 'expansion of the service portfolio', 'professional training, competencies and participation in professional education processes' and 'ambience and communication with the community'. The overall CVI was 0.91.

KEYWORDS
Primary Health Care; Validation studies; Health evaluation

DIMENSION	COMPONENTS	INDICATORS
User as the center of the process	Research for the analysis of the perception of the user about the care process: Primary Care Assessment Tool (PCATool-Brazil adults)	1. Research with users of health services.
Organization of processes focused on users	Portfolio of services, Access and link and Care Process	2. Expansion of the Service Portfolio. 3. Number of people linked to the team. 4. Hours of continued attention by the health team. 5. Expansion of forms of access. 6. Percentage of users linked to the health team and attended at the ECU. 7. Proportion of women aged 25 to 64 years who did not screen for cervical cancer. 8. Vaccine coverage of the linked population. 9. Appropriate treatment of syphilis of the linked patients, including the partner in the case of pregnant women. 10. Coverage of supervised tuberculosis treatment of linked patients. 11. Proportion of hospitalizations due to asthma in the linked population. 12. Coverage of supervised brushing in the schoolchildren of the School Health Program in schools linked to the team. 13. Coverage of examination to detect oral lesions in users over 40 years old, in the population linked to the team. 14. Coverage of first dental consultation in children under five years, in total in the linked population.
Link, competencies, skills and professional attitudes	Training, competencies and participation in the processes of professional and community education, productivity, effectiveness of primary health care and length of stay in the same team.	115. Professional training, competencies and participation in professional education processes. 16. Productivity evaluation based on previously established goals, by professional category. 17. Effectiveness of Primary Health Care as a percentage of referrals from users to specialists. 18. Length of stay in the same Basic Health Unit and team
Organizational Ambience	360º evaluation by the team and organization of the spaces of the Basic Health Units.	19. Organization of inputs of the Basic Health Units20. Organization of equipment. 21. Cleaning of the Basic Health Unit. 22. Ambience and communication with the community. 23. Peer assessment of professional attitudes, considering shift work.

Dimension	Indicators	CVI	Specialists who attributed the conceptscertainly relevant or probably relevant (N=60)
User as the center of the process	Research with users of health services	1,00	60
Organization of processes focused on users	Expansion of the Service Portfolio	1,00	60
	Number of people linked to the team	0,95	57
	Hours of continued attention by the health team	0,90	54
	Expansion of forms of access	0,93	56
	Percentage of users linked to the health team and attended at the Emergency Care Unit	0,82	49
	Proportion of women aged 25 to 64 years who did not screen for cervical cancer	0,97	58
	Vaccine coverage of the linked population	0,98	54
	Appropriate treatment of syphilis of the linked patients, including the partner in the case of pregnant women	0,97	58
	Coverage of supervised tuberculosis treatment of linked patients	0,97	58
	Proportion of hospitalizations due to asthma in the linked population	0,97	58
	Coverage of supervised brushing in the schoolchildren of the School Health Program in schools linked to the team	0,92	55
	Coverage of examination to detect oral lesions in users over 40 years old, in the population linked to the team	0,98	59
	Coverage of first dental consultation in children under five years, in total in the linked population	0,98	59
Link, competencies, skills and professional attitudes	Professional training, competencies and participation in professional education processes	1,00	60
	Productivity evaluation based on previously established goals, by professional category	0,92	55
	Effectiveness of Primary Health Care as a percentage of referrals from users to specialists	0,88	53
	Length of stay in the same Basic Health Unit and team	0,90	54
Organizational Ambience	Organization of inputs	0,97	58
	Organization of equipment	0,98	59
	Cleaning of the Basic Health Unit	0,96	58
	Ambience and communication with the community	1	60
	Peer assessment of professional attitudes, considering shift work	0,95	57
Total CVI		0,91

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[1] Conflict of interests: non-existent