Innovations in the national household random sampling in Brazilian National Health Survey: results from Starfield and Shi’s adult primary care assessment tool (PCAT)

International Journal for Equity in Health

Luiz Felipe Pinto¹  Otavio Pereira D’Avila²  Lisiane Hauser³  Erno Harzheim³ 

[1] Department of Medicine in Primary Health Care, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), 36 Laura de Araújo Street, Cidade Nova, 20551-031, Rio de Janeiro, RJ, Brazil;Post-Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), 2400 Ramiro Barcellos Street, Santa Cecília, 90035-003, Porto Alegre, RS, Brazil;Federal University of Pelotas (UFPel), 457 Gonçalves Chaves Street, Centro, 96015-560, Pelotas, RS, Brazil;Post-Graduate Studies Program in Epidemiology, Federal University of Rio Grande do Sul (UFRGS), 2400 Ramiro Barcellos Street, Santa Cecília, 90035-003, Porto Alegre, RS, Brazil;

关键词: Househould surveys;    PCAT;    Evaluation of health systems;    Primary care;    Brazil;    Inquéritos domiciliares;    PCAT;    Avaliação dos sistemas de saúde;    Atenção primária à saúde;    Brasil;   

DOI  :  10.1186/s12939-021-01455-w

来源: Springer

【 摘 要 】

BackgroundSeveral middle and upper income countries carry out household surveys that seek to trace the profile of access and use of health services. Probably one of the most ambitious examples is Brazil, with its National Health Survey (PNS-2019). We evaluated PNS-2019, presenting in an unprecedented way, one of its innovations, which refer to Starfield and Shi’s adult Primary Care Assessment Tool (PCAT).MethodsBased on a cross-sectional study, we evaluated Module H of the PNS-2019, which interviewed a probabilistic sample of about 10,000 adults in 2019 in all 27 Brazilian states. According to the PCAT methodology, an average score equal to or above 6.6 indicates a greater orientation and quality of the evaluated primary care services.ResultsBrazilian overall PCAT score [5, 9] reveals the need to improve primary health care services across the country. There were no statistically significant differences in the scores by sex (men and women, 5.9), and race (whites 5.9 [5.7; 6.0] and brown / black 5.9 [5.8; 6.0]). On the other hand, there was a difference in terms of age. The elderly evaluated the services in a more positive way (score = 6.1 [6.0; 6.2]), when compared to those aged 40–59 years (5.9 [5.7; 6.0]) and 18 to 39 years (5.6 [5.5; 5.8]). First results of PNS-2019 show that the population that most needs primary care services in SUS is the one with the best perception and the most positive evaluation of the actions and procedures offered in health facilities.DiscussionDuring 2019, Brazil undertook important structural reforms in PHC based on a new financing model with the aim of inducing an improvement in efficiency and strengthening its attributes. It is essential that countries with universal health coverage (UHC) guarantee access to their population and, especially, the most vulnerable, seek better efficiency of these services and regularly assess PHC based on the population’s perception, through an independent methodology that monitor the quality of services and the strength of PHC, generating value for public resources applied to health services.

【 授权许可】

CC BY