Acesso aos serviços de Atenção Primária à Saúde na perspectivas de profissionais: correlações entre o Primary Care Assessment Tool e o modelo conceitual de acesso universal
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Universidade Federal de Goiás
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Assis and Jesus (2012) propose an analysis model to understand universal access to health
services. The model considers five dimensions: political, economic-social, technical,
organizational, and symbolic. This study aimed to analyze access from the perspective of health
professionals. This is a multi-method (cross-sectional and methodological), quantitative study,
from 2021 to 2022 with nurses and doctors from PHC in the state of Goiás. The AFC analyzed
the items of the Primary Care Assessment Tool (PCATool) instrument and their relationship
with the dimensions of the model. Data collection was carried out through a validated
questionnaire, containing the first part with the sociodemographic profile and the second part
with questions divided into 9 components according to the essential and derived attributes of
the Primary Care Assessment Tool - PCATool (PCATool-Brazil) instrument. The questionnaire
data were analyzed by the statistical software R (R version 4.1.2; Vienna, Austria) (R Core
Team, 2021). To analyze access, a descriptive analysis was performed, and Confirmatory Factor
Analysis (CFA) was performed to analyze the dimensions of access. The results showed a
sample of 308 health professionals in the 47 municipalities that participated in the study. The
overall average age of the participants was 37.5 years, with a predominance of females (82.8%)
and self-declared white skin color (43.5%). The CFA found a correlation between the scores of
the items measured in the PCATool and the dimensions of the model, being significant for three
(organizational, technical and symbolic) of the five (political and economic-social) dimensions,
highlighting the attributes Comprehensiveness, Community Orientation and Family. The CFA
highlighted the main demands of access in PHC, dimensioned the scope of investigation of the
PCATool instrument and demonstrated the weaknesses of the instrument. Regarding the lack
of confirmation of the theoretical constructs of the political and economic-social dimensions,
assessing access through the PCATool may not reflect the reality of Brazilian services and
users, as well as bias political decision-making.
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ALVES, L. C. Acesso aos serviços de Atenção Primária à Saúde na perspectivas de profissionais: correlações entre o Primary Care Assessment Tool e o modelo conceitual de acesso universal. 2024. 107 f. Dissertação (Mestrado em Ensino na
Saúde) - Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, 2024.