2019, Number 3
Repercussions of the brazilian program for the assessment of quality of primary care
Language: Spanish
References: 22
Page: 1-17
PDF size: 159.95 Kb.
ABSTRACT
Introduction: The Brazilian Unified Health System, after 25 years of creation, is facing the challenge of assessment by means of the National Program for Improving Access and Quality of Primary Care.Objective: To analyze the repercussions of assessment in the working process of the evaluated family health teams.
Methods: Qualitative research, as a case study, carried out in a health region of the interior of São Paulo State, Brazil, made up by 18 municipalities, in the period from August 2016 to January 2017. Ten professional from family health team members participated, one from each municipality. The interviews were semi-structured and followed Bardin's thematic content analysis.
Results: The program was presented as an essential tool for identifying gaps, inducing critical reflections, and organizing the work process. The challenges that came up we the difficulty for implementing Integrative and Complementary Practices and the rotation of professionals. Some weaknesses were noted: the strong relationship between the tool and the transfer of financial resources, and the possibility of masking the actions in the teams at the face of the evaluator in the health service.
Conclusions: The National Program for Improving Access and Quality of Primary Care was presented as capable of inducing modifications related to the setting and to hard and soft-to-hard technologies. The strengthening of live work and light technologies in team work was identified.
REFERENCES
Castanheira ELR, Sanine PR, Zarilli TFT, Nemes MIB. Desafios para avaliação na Atenção Básica no Brasil: a diversidade de instrumentos contribui para uma cultura avaliativa? In: Akerman M, Furtado JP. Práticas de avaliação em saúde no Brasil-diálogos. Porto Alegre: Rede Reunida. 2015 [acceso: 27/01/2017]. p. 187-225. Disponible en: http://www.redeunida.org.br/editora/biblioteca-digital/serie-atencao-basica-e-educacao-na-saude/praticas-de-avaliacao-em-saude-no-brasil-dialogos-pdf
Ministério da Saúde (BR), Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica: Manual Instrutivo 3º ciclo (2015-2016) Brasília: Ministério da Saúde; 2015 [acceso: 21/03/2017]. Disponible en: http://www.rio.rj.gov.br/dlstatic/10112/6536378/4175279/ 01Manual_Instrutivo_ 3_Ciclo_PMAQ.pdf
Almeida MAS, Spiri WC, Casquel CM, Juliane M, Nunes LO, Placideli N, et al. O processo de avaliação do PMAQ-AB: olhar de uma equipe. In: Akerman M, Furtado JP. Práticas de avaliação em saúde no Brasil-diálogos. Porto Alegre: Rede Reunida; 2015 [acceso: 21/02/2017]. Disponible en: http://www.redeunida.org.br/editora/biblioteca-digital/serie-atencao-basica-e-educacao-na-saude/praticas-de-avaliacao-em-saude-no-brasil-dialogos-pdf
Macinko J, Harris MJ, Rocha MG. Brazil's National Program for Improving Primary Care Access and Quality (PMAQ) Fulfilling the Potential of the World's Largest Payment for Performance System in Primary Care. J Ambul Care Manage. 2017 [acceso: 21/08/2017];40(Suppl 2):s4-s11. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC5338882/
Garcia ACP, Andrade MAC, Contarato PC, Tristão FI, Rocha EMS, Rabello AE, et al. Ambiência na Estratégia Saúde da Família. Vigil sanit debate. 2015 [acceso: 21/01/2017];3(2):36-41. Disponible en: https://docs.google.com/viewerng/viewer?url= https://visaemdebate.incqs.fiocruz.br/index.php/visaemdebate/article/viewFile/484/226
Fausto MCR, Giovanella L, Mendonça MHM, Seidl H, Gagno J. A posição da estratégia saúde da família na rede de atenção à saúde na perspectiva das equipes e usuários participantes do PMAQ-AB. Saúde debate. 2014 [cited 2017 Feb 15];38(spe):13-33. Disponible en: http://www.scielo.br/pdf/sdeb/v38nspe/0103-1104-sdeb-38-spe-0013.pdf
Cruz MM, Souza RBC, Torres RMC, Abreu DMF, Reis AC, Gonçalves AL. Usos do planejamento e autoavaliação nos processos de trabalho das equipes de saúde da Família na atenção básica. Saúde debate. 2014 [acceso: 12/02/2017];38(spe):124-39. Disponible en: http://www.scielo.br/pdf/sdeb/v38nspe/0103-1104-sdeb-38-spe-0124.pdf
Machado JC, Cotta RMM, Soares JB. Reflexões sobre o processo de municipalização das políticas de saúde: a questão da descontinuidade político-administrativa. Interface comum saúde educ. 2015 [acceso: 19/03/2017];19(52):159-70. Disponible en: http://www.scielo.br/pdf/icse/v19n52/1807-5762-icse-19-52-0159.pdf