Avaliação dos serviços de atenção primária à saúde e a formação dos profissionais de saúde em São José de Ribamar-MA

Abstract

The concepts of Primary Health Care (PHC) expand the view of health care, requiring a change in the professional practice. The PHC assessment has been highlighted by the health systems crisis and the need for tools for management planning. The Primary Care Assessment Tool (PCATool) is one of the most used instruments in the evaluation of PHC in Brazil and worldwide. This research analyzed the socio-demographic and professional training profile of the higher education professionals of the FHS teams in the municipality of São José de Ribamar-MA, the quality of PHC services from the professionals' point of view and the relationship between these two factors (training and quality). This is a cross-sectional study, carried out with 2 questionnaires: a self-administered one to profile professionals and an interview with PCATool professional version to evaluate the quality of PHC services. 73 professionals from the FHS teams participated in the study. Data were analyzed with Stata version 14.2 program. The variables were analyzed using multivariate regression, Poisson regression with robust variance and the prevalence ratio (PR) with 95% confidence intervals (95% CI) was presented as a measure of effect. The results showed a predominance of women, professionals with up to 50 years and specialization in Family Health Care. Most were working less than 5 years in the FHS and in the same team, and about 90% participated in training in the last year. Assessment of PHC attributes resulted in a high overall PHC score (7.5). Access essential attribute score was the lowest (3.9) and the highest scores were in Coordination/information system (8,9) and Family Orientation (8,9). The highest scores in the derived attributes were statistically associated to the group of PMM professionals and to the longer time of performance in the FHS. No statistically significant relationship was found between the other attributes and the socioeconomic and professional training profile. Therefore, the FHS teams from São José de Ribamar were oriented to APS according to PCATool from the perspective of the professionals who work in it. Considering the PHC model evaluated by this instrument, it is worth highlighting the need for a better evaluation of the Structure and Outcome components of Primary Care in São José de Ribamar. The higher education human resources of the FHT teams present training and link characteristics that generate the evaluation of the quality of PHC services presented in this study. Although most are specialists in family health and have performed training in the last year, these activities did not have a reflex in practice, suggesting more studies to understand this relationship.