Avaliação da estratégia saúde da família de municípios de médio porte de Minas Gerais: possibilidades e limites da utilização de dados secundários

Abstract

The health policies in Brazil through paths that lead to the primary health care (PHC) as a model for prioritized assistance to public health. In the 80s, the PHC is called Basic Care (BC) and has in the Family Health Strategy (FHS), the reaffirmation of the principles’ unified health system (SUS) as a priority strategic for the health sector’s organization. The expansion of the BC and the FHS and its consolidation are driving the need for evaluating these programs. Systems health information (SHI) provides useful data to create indicators for the evaluation such as indicators of the BC and hospitalization for ambulatory care sensible conditions (ACSC). The objective was to assess the FHS's medium-sized municipalities in Minas Gerais based on secondary data. Specific objectives were to assess the adequacy of the BC and the ACSC indicators in the evaluation of these municipalities and the association between the FHS and the changes in health indicators and their plausibility, to discuss the quality of the SHI and data that make up these indicators municipalities. The selected cities have a population between 50 and 100 thousand in the estimate of 2005 and the years studied were 2000 and 2005. The indicators selected were divided into two groups, one outcome (results) divided into components, Maternal and Child health and General health and other factors (determinants) divided into BC, hospital and socio-economic and demographic. The statistical indicators were performed, followed by analysis of the associations. The analysis’ results of data showed an association between protective factors related to primary care and maternal and child health, factors related to hospital characteristics were associated with the outcomes of hospitalization and the social, economic and demographic factors had little effect the results, sometimes appearing only as a confounding factor. We conclude with the study, the influence of the characteristics and peculiarities of cities in the evaluation, we observed a positive relationship of BC in some indicators, the adequacy of the indicators of the BC and the ACSC, the difficulty of proving both the plausibility because of the model study and the unique characteristics of these municipalities and the quality of the sis.