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Primary Care Evaluation in the Brazilian Context: Effects of the Health Care Model Transition.

Ana Paula Scoleze Ferrer, Alexandra Brentani, Sandra Josefina Ferraz Ellero Grisi

Introduction: Literature has already described the benefits of Primary Health Care (PHC). The high heterogeneity in quality of provided care affects health outcomes. Studies that evaluate health care have been considered essential to identify possible gaps and action priorities. The Brazilian health system, especially Primary health care organization have been under reform and currently, we are amid a transition from what we call the “traditional model” to the Family Health Strategy (FHS). Albeit many studies had proved the advantages of the FHS model, other undertaken evaluations show inconsistent results. Persistent high rates of Hospitalizations due to Ambulatory Care Sensitive Conditions (ACSC) still pose a challenge to both models and demands further investigation.

Objective: To evaluate the attributes of primary care offered to children hospitalized due to ACSC, comparing the two models of primary care.

Methods: We used a cross-sectional design with a quantitative approach. Sample comprises children admitted to the pediatric ward diagnosed with ACSC. Data collection followed the criteria of the Primary Care Assessment Tool (PCATool - Brazil). Independent variables were: age, maternal literacy, family income, type of diagnosis and model of care offered, dependent variables were PHS attributes according to Starfield’s referential. Results: 65.2% of total hospitalizations were due to ACSC; 501 users were interviewed; attributes showed lower orientation to the PHC principles but model of care influenced the results.

Conclusion: There was a low orientation to the principles of PHC, with the exception of the coordination attribute. PHS services were better evaluated by FHS users.