Avaliação dos atributos da Atenção Primária à Saúde na perspectiva dos profissionais

Abstract

Introduction: Primary Health Care is considered the center of the Brazilian health system, with high potential for solving the health needs of the population. Given its importance, its monitoring and evaluation becomes relevant. Objective: To evaluate the presence and extension of attributes of Primary Health Care from the perspective of professionals. Methods: This is an evaluative cross-sectional study conducted in 62 Primary Health Care Units in the city of Juiz de Fora, Minas Gerais, from March 2018 to February 2019. Data were collected by means of self-application of the primary care assessment tool - Primary Care Assessment Tool Brazil, professional version. The study included 540 professionals, 52 doctors, 85 nurses, 92 nursing technicians and 311 community health agents. The database was created using Epi-Info version 7.2.2 software and statistical analysis was performed using the Statistical Package for Social Sciences for Windows 22 (SPSS) software. General, essential and derived scores and scores were assigned to each attribute (accessibility, longitudinality, coordination, completeness, family orientation and community orientation). Mean scores equal to or greater than 6.6 indicate high service orientation for attributes. Results: the overall score indicated low service orientation from the perspective of professionals. The essential attributes longitudinality, coordination (information systems) and completeness (available services) and the derived attributes (family orientation and community orientation) were highly oriented. The comparison of the scores by professional category did not identify significant difference. Regarding the modalities of services, the FSEs presented significantly higher scores in the attributes longitudinality, comprehensiveness of services provided and family orientation. In the comparison between regions, the rural area presented better orientation for the attributes accessibility, coordination (integration of care / information systems) and essential and general scores. The working time of professionals was positively associated with the longitudinality attribute, and the presence of specialization and family health residency were positively associated with the longitudinality and coordination (care integration) attributes. Conclusion: the study identified the presence and extension of attributes, pointed out weaknesses, potentialities and possibilities for the service, both at the organizational level, and the work process of professionals, aiming at qualified attendance to the health needs of the local population. We highlight the role of the professional nurse, whose role is linked to the management of most health units, and therefore recognized as a professional with high potential to coordinate and influence the operationalization of attributes in the daily routine of services. It brought a technological and economic impact by presenting contributions to the improvement of local service and social and professional impact by identifying that training focused on primary health care and the permanence of professionals in the team are associated with better results. It also identified the importance of permanent evaluation of the service, suggesting further studies. It is recommended to monitor the attributes in the primary service of Juiz de Fora by self-application of PCATool.