Institutional and matrix support and its relationship with primary healthcare

OBJECTIVE To analyze whether the level of institutional and matrix support is associated with better certification of primary healthcare teams.METHODS In this cross-sectional study, we evaluated two kinds of primary healthcare support – 14,489 teams received institutional support and 14,306 teams received matrix support. Logistic regression models were applied. In the institutional support model, the independent variable was “level of support” (as calculated by the sum of supporting activities for both modalities). In the matrix support model, in turn, the independent variables were the supporting activities. The multivariate analysis has considered variables with p RESULTS The teams had institutional and matrix supporting activities (84.0% and 85.0%), respectively, with 55.0% of them performing between six and eight activities. For the institutional support, we have observed 1.96 and 3.77 chances for teams who had medium and high levels of support to have very good or good certification, respectively. For the matrix support, the chances of their having very good or good certification were 1.79 and 3.29, respectively. Regarding to the association between institutional support activities and the certification, the very good or good certification was positively associated with self-assessment (OR = 1.95), permanent education (OR = 1.43), shared evaluation (OR = 1.40), and supervision and evaluation of indicators (OR = 1.37). In regards to the matrix support, the very good or good certification was positively associated with permanent education (OR = 1.50), interventions in the territory (OR = 1.30), and discussion in the work processes (OR = 1.23).CONCLUSIONS In Brazil, supporting activities are being incorporated in primary healthcare, and there is an association between the level of support, both matrix and institutional, and the certification result.</sec

Percepção dos usuários sobre o cuidado prestado por equipes participantes do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica no Brasil

Resumo Objetivo: analisar a percepção dos usuários sobre o cuidado prestado por equipes participantes do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) no Brasil. Métodos: estudo transversal com dados de entrevistas com usuários das equipes, em 2012. Empregou-se regressão logística multinomial para analisar a associação entre nível de percepção (muito bom/bom, regular, ruim/muito ruim) e variáveis de quatro atributos da atenção básica: acessibilidade, integralidade, longitudinalidade e coordenação do cuidado. Resultados: dos 65.391 entrevistados, 78,9% avaliaram o atendimento como muito bom/bom, 19,0% como regular e 2,1% como ruim/muito ruim. A avaliação muito bom/bom foi associada a questões sobre os quatro atributos estudados. Destacam-se as associações com atendimento pelo mesmo médico (OR 3,21; IC95% 2,68; 3,83) e realização do exame físico na consulta (OR 3,08; IC95% 2,50; 3,79). Conclusão: a maioria dos usuários avaliou positivamente o atendimento, contudo existe percepção de problemas no cuidado conforme os atributos recomendados

Institutional and matrix support and its relationship with primary healthcare

OBJECTIVE To analyze whether the level of institutional and matrix support is associated with better certification of primary healthcare teams.METHODS In this cross-sectional study, we evaluated two kinds of primary healthcare support &#8211; 14,489 teams received institutional support and 14,306 teams received matrix support. Logistic regression models were applied. In the institutional support model, the independent variable was &#8220;level of support&#8221; (as calculated by the sum of supporting activities for both modalities). In the matrix support model, in turn, the independent variables were the supporting activities. The multivariate analysis has considered variables with p < 0.20. The model was adjusted by the Hosmer-Lemeshow test.RESULTS The teams had institutional and matrix supporting activities (84.0% and 85.0%), respectively, with 55.0% of them performing between six and eight activities. For the institutional support, we have observed 1.96 and 3.77 chances for teams who had medium and high levels of support to have very good or good certification, respectively. For the matrix support, the chances of their having very good or good certification were 1.79 and 3.29, respectively. Regarding to the association between institutional support activities and the certification, the very good or good certification was positively associated with self-assessment (OR = 1.95), permanent education (OR = 1.43), shared evaluation (OR = 1.40), and supervision and evaluation of indicators (OR = 1.37). In regards to the matrix support, the very good or good certification was positively associated with permanent education (OR = 1.50), interventions in the territory (OR = 1.30), and discussion in the work processes (OR = 1.23).CONCLUSIONS In Brazil, supporting activities are being incorporated in primary healthcare, and there is an association between the level of support, both matrix and institutional, and the certification result

Incorporação de Tecnologias de Informação e Comunicação e qualidade na atenção básica em saúde no Brasil

Resumo: As Tecnologias de Informação e Comunicação (TIC) - meios para tratar informação e agilizar comunicação - contribuem para o cuidado. Este artigo descreve a incorporação de TIC na atenção básica e sua associação com a qualidade, utilizando Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ). É um estudo transversal. O universo englobou 17.053 equipes. Criou-se o Índice de Incorporação de Tecnologias de Informação e Comunicação (ITIC) englobando: infraestrutura, sistemas e utilização de informação. Para as associações, realizou-se análise de regressão. Somente 13,5% das equipes possuem grau alto de TIC. É na utilização da informação que se observou a maior força de associação. As TIC contribuem para a melhoria da qualidade da atenção básica

Compreendendo o apoio matricial e o resultado da certificação de qualidade nas áreas de atenção à criança, mulher, diabetes/hipertensão e saúde mental

Este artigo apresenta a distribuição do apoio matricial (AM) no Brasil, identificando relações entre as atividades de AM e a certificação do PMAQ-AB. Utilizaram-se dois modelos de regressão logística múltipla. As atividades de AM na Atenção Básica são significativas mas desiguais, com altos graus de AM em lugares desenvolvidos. Existe associação positiva entre o grau de apoio e o resultado obtido na certificação. Elevados graus de AM correspondem a 89%, 80%, 89% e 63% de chances de as equipes obterem uma melhor certificação na atenção à mulher, criança, hipertensão e diabetes e saúde mental, respectivamente. O AM tem ajudado a melhorar a qualidade da Atenção Básica no Brasil