Avaliação da qualidade da Atenção Primária à Saúde em Fortaleza, Brasil, na perspectiva dos usuários adultos no ano de 2019
Lourrany Borges Costa, Maria Vaudelice Mota, Magda Moura de Almeida, Carla Salles Gazeta Vieira Fernandes, Eveline Torquato Santos, João Pedro Marques de Oliveira, Thayná Custódio Mota, Andrea Da Porto, Maria Nice Almeida Alencar
Abstract
Primary Health Care (PHC) is the "front door" and keystone of Brazil's public health system, meaning that the evaluation of the quality of primary care services is of utmost importance. Using the Primary Care Assessment Tool (PCAT), this study evaluated the performance of public PHC services in Fortaleza from the view of adult service users. We conducted a cross-sectional study of 233 adult service users from 19 primary care centers (PCCs) between June and December 2019, collecting data on the sociodemographic and epidemiological characteristics of users and structural features of PCCs. The association between user and PCC characteristics and primary care attribute scores was measured by multilevel logistic regression. Most participants were women, aged between 30 and 59 years, brown, house owners, had completed high school, did not own health insurance, and belonged to families with at least 4 members. The lowest and highest-scoring attributes were "first contact accessibility" and "first contact utilization" (2.8 and 8.1, respectively). The overall essential and general scores were 6.0 and 5.7, respectively. Having complete health teams, more community health workers, and a family and community medicine residency program had a positive effect on the general score (p<0.05). Overall, the public services analyzed in Fortaleza received a low performance rating from the adult service users.