Assessment of health units, Family Health teams and Walk'in clinics using the primary care assessment tool

• Grant number: 13/03704-9
• Support Opportunities: Regular Research Grants
• Start date: December 01, 2013
• End date: November 30, 2015
• Field of knowledge: Health Sciences - Collective Health - Public Health
• Principal Investigator: Gustavo Diniz Ferreira Gusso
• Grantee: Gustavo Diniz Ferreira Gusso
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Health centers since they were implemented in Brazil in the first half of the twentieth century underwent many transformations. Up to the Constitution of 1988 the Ministry of Health had the prerogative of prevention and promotion while the Ministry of Social Welfare was the responsibility of care. With the advent of the Unified Health System (SUS) these actions were unified in the Ministry of Health with consequences for Primary Care. The creation of the Family Health Program in 1994, transformed into the Family Health Strategy in 1997 was a natural process to meet the demand created by this integration between prevention, cure and rehabilitation. Today the Family Health Strategy covers approximately 50% of the population and has more than 1000 staff in the city of São Paulo. However, there has been high demand for consultations and because the high number of people covered by each team forced governments to create services for unscheduled consultations or minor emergencies, worldwide called Walk`in Clinics. While the rest of Brazil this service is known as Fast Care Unit (UPA), in São Paulo was named Ambulatory Healthcare (AMA). Because their role is first contact, they can be considered mostly outpatient primary care services. To measure the effectiveness of primary there are some methodologies. The Ministry of Health launched the Programme for Improving Access and Quality (PMAQ) whose instrument is not validated, what makes this analysis mostly qualitative. Worldwide the most used instrument, and validated for Brazil, is the Primary Care Assessment Tool (PCATool) that follows the nuclear attributes of primary care: access, coordination, comprehensiveness and longitudinality. Methodology:Three axes will be created. The first will be the main application, aimed the adult and child versions of PCATool for the population of the four Family Health Strategy (ESF) who receive family medicine residents and medical students of the University of São Paulo. The questionnaires will also be applied to patients through convenience sample (consecutive patients) of the four services that are Ambulatory Medical Care managed by the Foundation of Faculty of Medicine of the University of São Paulo. The second axis will apply the version for health professionals of PCATool for doctors and nurses of the same teams. In the third axis will be visited homes by random sampling to evaluate the degree of affiliation, ie to assess which services the region's population adopts as gateway to the health system. (AU)