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Use of a tool for analysis of quality public health services

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Author(s):
Luciana Fernandes Volpato
Total Authors: 1
Document type: Doctoral Thesis
Press: Piracicaba, SP.
Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
Defense date:
Examining board members:
Marcelo de Castro Meneghim; Silvia Amélia Scudeler Vedovello; Luciane Zanin; Antonio Carlos Pereira; Gláucia Maria Bovi Ambrosano
Advisor: Marcelo de Castro Meneghim
Abstract

The Unified Health System (SUS) assured to every citizen the right to efficient health services and quality. However, the efficiency and quality of service are questioned because several people, lacking adequate care and assistance, have remained awaiting care due to lack of vacancies for consultations and insufficient number of professionals. Against difficulties in public health and in order to more qualified services in October 1995, the proposal of the Health System Administrative Reform was presented Brazil, stating that public services could be transformed into social organizations (OS). As part of the management process, quality planning is essential for obtaining more efficient and skilled and thus services, Function Deployment tool Quality (QFD) was selected to analyze the quality of service in Unit Family Health (USF). This study was presented in an alternative format and consists of three chapters. Chapter 1 aimed to determine the perceptions of users and professionals on quality in health services through a systematic review. The results showed that primary care was the object of analysis application in most studies and the perception of users, more measured. It was concluded that in primary care, a good professional -user relationship, the appropriate number of professional and good conditions in the physical structure were common to users and professional items. The average complexity presented the item to easily schedule common query to the perception of users and professionals. A good professional-user relationship was the common perception of users and professionals of high complexity. The aim of Chapter 2 was to assess quality in four USF managed by an OS, through the perception of users and professionals, using the QFD tool. The results showed, as perceived by the users, the need for improvement in the items: facility to schedule appointments at USF, friendly, attentive and quick service, lower staff turnover, punctuality in medical and professional motivation. For professionals, necessary for the improvement of the service requirements were: continuing education, professional and financial incentives and the need to reduce the number of registered families. The OS was created to provide more efficient and quality health services, and thus meet the needs of its users. However, this fact has not been proven in research. Chapter 3 presented to evaluate access in eight USF, managed by an OS or not, from the perspective of users and professionals, using QFD. The results showed that the USF managed by the OS, the most important item was the users the facility to schedule appointments in the unit. In USF unmanaged by the OS, the facility to schedule appointments in specialized service and drive was reported as the most important item. It was concluded that USF managed by the OS did not obtain better results in the quality of access compared the USF not managed by the OS (AU)