Primary health care organization in municipalities of São Paulo, Brazil

A model of care aligned with the Brazilian Unified National Health System's guidelines

Dados Bibliográficos

ID5167916
AutoresElen Rose Lodeiro Castanheira (0000-0002-4587-7573, Universidade Estadual Paulista (Unesp), autor correspondente), Lígia Schiavon Duarte (0000-0001-5822-9033, Secretaria de Estado da Saúde de São Paulo, Brasil), Mônica Martins De Oliveira Viana (0000-0003-3049-4518, Secretaria de Estado da Saúde de São Paulo, Brasil), Luceime Olívia Nunes (0000-0001-6505-1800, Universidade Estadual Paulista (Unesp)), Thais Fernanda Tortorelli Zarili (0000-0002-0690-2334, Universidade Estadual do Oeste do Paraná), Carolina Siqueira Mendonça (0000-0002-2697-4992, Universidade Estadual Paulista (Unesp)), Patricia Rodrigues Sanine (0000-0002-7668-0327, Universidade Estadual Paulista (Unesp))
Ano2024
Volume40
Fascículo2
PáginasPT099723-PT099723
Data de publicação2024-01-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoCadernos de Saude Publica (JOURNAL)
Identificadores do periódicoISSN: 0102-311X • E-ISSN: 1678-4464
EditoraFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/0102-311xen099723
PMID38422250
OpenAlexW4392172886
IdiomaPT
Referências citadas33

This study analyzes the main organization patterns used by primary health care (PHC) services in municipal networks and evaluates them according to indicators of local management-administration interface. Evaluative research analyzed 461 municipalities in São Paulo, Brazil, that participated in the Primary Care Services Quality Assessment Survey (QualiAB) in 2017/2018, classified according to the organizational arrangements composition of 2,472 PHC services. Eight indicators of local management and administration were selected to evaluate the identified patterns. Results indicate two groups of municipalities: homogeneous, with services presenting the same arrangement (43.6%); and heterogeneous, with different arrangements (56.4%). These were subdivided into seven patterns that ranged from homogeneous-traditional, homogeneous-Family Health Strategy, homogeneous-mixed, and different combinations in the heterogeneous group. All indicators showed significant differences between groups (p < 0.001), especially the homogeneous-traditional group, which presented an organizational pattern far from the desired model of a comprehensive and problem-solving PHC. Those integrated with family health units (FHU) and basic health units with community health workers and/or family health teams (BHU/FHU) showed a pattern closer to a comprehensive model - with planning and evaluation actions committed to the local reality and qualification of care. Implementation of federal and state policies are essential for defining the PHC health care model adopted by municipalities

Environmental health · Family medicine · Health care · Healthcare system · Political science · Population · Primary care · Primary health care · Health, Nursing, Elderly Care · Medicine · Nursing · Primary Care and Health Outcomes · Public Health in Brazil · Gerontology