Evaluation of the primary care for chronic diseases in the high coverage context of the Family Health Strategy
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2019
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Background: This cross-sectional study evaluated the adequacy of the Family Health Strategy for the primary care
model for chronic noncommunicable diseases and the changes that occurred between the two cycles of external
evaluations of the National Program for Improving Access and Quality of Primary Care, which took place in 2012
and 2014, in the higher coverage context of the Family Health Strategy of Brazil, in the state of Tocantins, Brazil.
Methods: The data source contained information on the infrastructure of the 233 Primary Health Units and on the
work process of 266 health teams. The Principal Component Analysis for Categorical Data technique and the
McNemar chi-squared statistical test for comparing paired samples were used, and a significance level of 5% with a
95% Confidence Interval was used.
Results: The analysis identified a low proportion of dispensing of medications for the treatment of chronic disease
in both cycles. There was a significant increase in seasonal influenza vaccination, in the number of sterilization,
procedure, dressings and inhalation rooms. There was a small but significant reduction in the materials for cervical
cancer screening, although they are available in almost 90.0% of the PHUs. More than 70.0% of the health teams
carried out additional health education activities, encouraged physical activity, registered schoolchildren with health
needs for monitoring, evaluated user satisfaction and user referral.
Conclusions: The findings of this study highlighted the improvement of the structure of the Primary Health Units,
but identified a low provision of medicines to treat chronic diseases. The health promotion was performed as the
main work process tool of family health teams, but it was little focused on intersectoral actions and on actions with
the population in the area or on the empowerment of users through self-management support for chronic diseases.
Furthermore, it is critical that the Family Health Strategy in Tocantins be organized and focused on the care of chronic
diseases to improve and adapt itself to a primary chronic care model.
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Primary health care, Family practice, Primary care model, Noncommunicable disease, Chronic diseases, Chronic care model, Evaluation of care, Quality of care, Brazil
Citação
ALVES, Kelly Cristina Gomes et al. Evaluation of the primary care for chronic diseases in the high coverage context of the Family Health Strategy. BMC Health Services Research, Berlin, v. 19, e913, 2019. DOI: 10.1186/s12913-019-4737-2. Disponível em: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4737-2. Acesso em: 25 mar. 2025.