Desempenho da atenção primária à saúde, segundo clusters de municípios convergentes no estado de São Paulo

Revista Brasileira de Epidemiologia

article

Pinheiro Junior, Raimundo Valdemy Borges¹  Carneiro Junior, Nivaldo²  Sala, Arnaldo³  Luppi, Carla Gianna¹  Schveitzer, Mariana Cabral¹  Andrade, Marta Campagnoni²  Rufino, Edson²  Fogaça, Lissandra Zanovelo¹  Simões, Oziris²  Wagner, Gabriela Arantes¹ 

[1] Universidade Federal de São Paulo;Faculdade de Ciências Médicas da Santa Casa de São Paulo;São Paulo State Health Department

关键词: Primary health care;    Health status indicators;    Outcome and process assessment;    health care;    Cluster analyses;   

DOI  :  10.1590/1980-549720220017

学科分类：社会科学、人文和艺术（综合）

来源: SciELO

【 摘 要 】

Objective: To describe the performance of Primary Health Care, according to conglomerates of São Paulo cities that present homogeneous indicators.Methods: This is a descriptive study, based on secondary data extracted from official sources of the Unified Health System, for the year 2018. An analysis matrix was created, with the proposition of performance (access, effectiveness and adequacy) and context indicators (population, health determinants and financing) selected and organized in dimensions and sub-dimensions. Cluster Analysis was used to identify the groups of homogeneous municipalities.Results: 645 municipalities were divided in 6 conglomerates. Clusters 2 and 3 were formed predominantly by small municipalities with greater access to health; cluster 3 has less social vulnerability and greater investment in health. Clusters 1, 4 and 5 were formed by the largest municipalities with less access to health; cluster 4 presents greater social vulnerability, less coverage of private health plans and a greater percentage of health resources; cluster 5 was characterized by greater Gross Domestic Product per capita and greater coverage of private health plans. Cluster 6, formed by the city of São Paulo, was a particular case. Cluster 2 drew attention, as it was shown to have increased coverage, but signaled lower efficacy and adequacy levels. Cluster 3 had the best performance among all clusters.Conclusion: These findings can support regional and municipal management, given the complexity of the territory of São Paulo, pointing to scenarios that demand broader public management initiatives.

【 授权许可】

CC BY-NC