Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB

Detalhes bibliográficos
Ano de defesa: 2019
Autor(a) principal: Barreto, Raissa Mont´Alverne
Orientador(a): Albuquerque, Izabelle Mont'Alverne Napoleão
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Não Informado pela instituição
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://www.repositorio.ufc.br/handle/riufc/46005
Resumo: Primary Care has Family Health as a priority strategy for its organization, with indisputable advances, but there are still many problems that need to be addressed so that it can play its role as coordinator of health care. Thus, the need to carry out evaluative quality surveys of Primary Health Care emerges due to its capillarity of actions aimed at the majority of the population. The objective of this study was to evaluate the quality of Primary Care of the city of Sobral, Ceará within the dimensions Structure and Process, from the Donabedian referential. It is an evaluative research under the quantitative and qualitative approaches. For the collection of the quantitative data an adaptation of the Instrument of Evaluation of Basic Attention Services (QualiAB) with the managers and teams of health of the family, was inserted in a free software of web platform called LimeSurvey. For the qualitative data, semi-structured interviews were conducted with managers of the Units in order to collect information about the perception of these actors regarding the evaluation process and possible impacts resulting from this process. To analyze the qualitative data, a Bardin content analysis was performed with the support of the software N Vivo11, and for the analysis of the quantitative data the QualiABSobral tool was built, which was developed in a web platform and fed by importing the data inserted in the software used to collect the data. Simple descriptive statistics techniques were also used, from tabulation, data processing and table production by the Excel program. In general, for the structure dimension, good performance was observed, but it is worth emphasizing aspects that compromise this assistance, such as the fact that three Units are without a doctor and 50% of them present a smaller number of teams than the one recommended by PNAB, in high care demands. In addition, it was visualized the need for improvements in accessibility for people with disabilities; insufficient emergency and emergency equipment; absence of vehicle for use by the Unit; and deficiency in the availability of some drugs. For the process dimension, good results were observed, but it is necessary to reflect on the scheduling of the consultations; waiting time between referrals, specialist consultations and examinations; routine care of the child; greater emphasis on health care for man and the worker; and strategies to stimulate popular participation. The results of the interviews with the managers brought qualitative contributions and allowed identifying factors that deserve to be highlighted for the improvement of the quality of care, such as a greater valuation of the evaluation processes to contribute to the planning and management of the local health system in an efficient, and satisfactory; greater commitment between Primary Care and Health Care Networks to simplify and make effective the counterreference process in order to value the continuity of care; minimization of bureaucratic processes linked to management and simplification in filling spreadsheets to generate health indicators that are compatible between services. Thus, the results allow obtaining information essential to strategic decision making by managers and a broader picture of the actual situation of Sobral, besides contributing to the elaboration of a planning based on the needs and propositions of improvements for the qualification of the assistance rendered to the population of the studied municipality.
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spelling Barreto, Raissa Mont´AlverneAlbuquerque, Izabelle Mont'Alverne Napoleão2019-09-23T12:29:30Z2019-09-23T12:29:30Z2019-05-29BARRETO,R.M. Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB. 2019. 190 f. Dissertação (Mestrado em Saúde da Família) Campus Sobral, Universidade Federal do Ceará, Sobral,2019.http://www.repositorio.ufc.br/handle/riufc/46005Primary Care has Family Health as a priority strategy for its organization, with indisputable advances, but there are still many problems that need to be addressed so that it can play its role as coordinator of health care. Thus, the need to carry out evaluative quality surveys of Primary Health Care emerges due to its capillarity of actions aimed at the majority of the population. The objective of this study was to evaluate the quality of Primary Care of the city of Sobral, Ceará within the dimensions Structure and Process, from the Donabedian referential. It is an evaluative research under the quantitative and qualitative approaches. For the collection of the quantitative data an adaptation of the Instrument of Evaluation of Basic Attention Services (QualiAB) with the managers and teams of health of the family, was inserted in a free software of web platform called LimeSurvey. For the qualitative data, semi-structured interviews were conducted with managers of the Units in order to collect information about the perception of these actors regarding the evaluation process and possible impacts resulting from this process. To analyze the qualitative data, a Bardin content analysis was performed with the support of the software N Vivo11, and for the analysis of the quantitative data the QualiABSobral tool was built, which was developed in a web platform and fed by importing the data inserted in the software used to collect the data. Simple descriptive statistics techniques were also used, from tabulation, data processing and table production by the Excel program. In general, for the structure dimension, good performance was observed, but it is worth emphasizing aspects that compromise this assistance, such as the fact that three Units are without a doctor and 50% of them present a smaller number of teams than the one recommended by PNAB, in high care demands. In addition, it was visualized the need for improvements in accessibility for people with disabilities; insufficient emergency and emergency equipment; absence of vehicle for use by the Unit; and deficiency in the availability of some drugs. For the process dimension, good results were observed, but it is necessary to reflect on the scheduling of the consultations; waiting time between referrals, specialist consultations and examinations; routine care of the child; greater emphasis on health care for man and the worker; and strategies to stimulate popular participation. The results of the interviews with the managers brought qualitative contributions and allowed identifying factors that deserve to be highlighted for the improvement of the quality of care, such as a greater valuation of the evaluation processes to contribute to the planning and management of the local health system in an efficient, and satisfactory; greater commitment between Primary Care and Health Care Networks to simplify and make effective the counterreference process in order to value the continuity of care; minimization of bureaucratic processes linked to management and simplification in filling spreadsheets to generate health indicators that are compatible between services. Thus, the results allow obtaining information essential to strategic decision making by managers and a broader picture of the actual situation of Sobral, besides contributing to the elaboration of a planning based on the needs and propositions of improvements for the qualification of the assistance rendered to the population of the studied municipality.A Atenção Primária tem a Saúde da Família como estratégia prioritária para sua organização com avanços incontestáveis, porém ainda há muitos problemas que precisam ser manejados para que possa desempenhar seu papel de coordenadora do cuidado em saúde. Assim, emerge-se a necessidade de realização de pesquisas avaliativas de qualidade da Atenção Primária à Saúde em virtude da sua capilaridade de ações destinada a maioria da população. O objetivo deste estudo foi avaliar a qualidade da Atenção Primária da cidade de Sobral, Ceará dentro das dimensões Estrutura e Processo, a partir do referencial de Donabedian. Trata-se de uma pesquisa avaliativa sob as abordagens quantitativa e qualitativa. Para coleta dos dados quantitativos utilizou-se uma adaptação do Instrumento de Avaliação de Serviços de Atenção Básica (QualiAB), com os gerentes e equipes de saúde da família, o qual foi inserido em um software livre de plataforma web denominado LimeSurvey. Para os dados qualitativos, foram realizadas entrevistas semiestruturadas com gerentes das Unidades a fim de coletar informações sobre a percepção destes atores quanto ao processo avaliativo e possíveis impactos decorrentes deste processo. Para análise dos dados qualitativos foi realizada análise de conteúdo de Bardin com o suporte do software N Vivo11, e para análise dos dados quantitativos foi construída a ferramenta QualiABSobral, a qual foi desenvolvida em plataforma web e alimentada a partir da importação dos dados inseridos no software utilizado na coleta dos dados. Foram utilizadas também técnicas de estatística descritiva simples, a partir da tabulação, processamento dos dados e produção das tabelas pelo programa Excel. De forma geral, para a dimensão estrutura constatou-se bom desempenho, mas vale ressaltar aspectos que comprometem esta assistência, como o fato de três Unidades estarem sem médico e 50% delas apresentarem quantidade de equipes inferior ao recomendado pela PNAB, refletindo, consequentemente, na alta demanda assistencial. Além disso, visualizou-se a necessidade de melhorias na acessibilidade para portadores de deficiência; insuficiência de equipamentos de urgência e emergência; ausência de veículo para uso da Unidade; e deficiência na disponibilidade de alguns medicamentos. Para a dimensão processo, observou-se bons resultados, mas é preciso reflexões sobre o agendamentos das consultas; tempo de espera entre encaminhamentos, consultas com especialista e realização de exames; atendimento de rotina da criança; maior ênfase para a atenção à saúde do homem e do trabalhador; e estratégias para estimular a participação popular. Os resultados das entrevistas com os gerentes trouxeram contribuições qualitativas e permitiram identificar fatores que merecem destaque para a melhoria da qualidade da atenção, tais como uma maior valorização dos processos avaliativos para contribuir para o planejamento e gestão do sistema local de saúde de forma eficiente, resolutiva e satisfatória; maior empenho entre a Atenção Primária e Redes de Atenção à Saúde para simplificar e efetivar o processo de contrarreferência no sentido de valorizar a continuidade do cuidado; minimização dos processos burocráticos ligados à gerência e simplificação no preenchimento das planilhas para gerar indicadores de saúde que sejam compatíveis entre os serviços. Assim, os resultados permitem a obtenção de informações essenciais à tomada de decisões estratégicas pelos gestores e uma imagem mais ampla da situação real de Sobral, além de contribuir para a elaboração de um planejamento baseado nas necessidades e proposições de melhorias para a qualificação da assistência prestada à população do município estudado.Avaliação em saúdeAtenção Primária à SaúdeAtenção à saúdeAvaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiABQuality assessment of Primary Health Care in the municipality of Sobral, Ceará from QualiABinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisporreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccessORIGINAL2019_dis_rmbarreto.pdf2019_dis_rmbarreto.pdfBARRETO,R.M. Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB. 2019. 190 f. Dissertação (Mestrado em Saúde da Família) Campus Sobral, Universidade Federal do Ceará, Sobral,2019.application/pdf2786535http://repositorio.ufc.br/bitstream/riufc/46005/3/2019_dis_rmbarreto.pdfa080e90e8c97060d5761bc760b7d3f9dMD53LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://repositorio.ufc.br/bitstream/riufc/46005/4/license.txt8a4605be74aa9ea9d79846c1fba20a33MD54riufc/460052021-10-20 15:53:48.508oai:repositorio.ufc.br:riufc/46005Tk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo=Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2021-10-20T18:53:48Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.pt_BR.fl_str_mv Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
dc.title.en.pt_BR.fl_str_mv Quality assessment of Primary Health Care in the municipality of Sobral, Ceará from QualiAB
title Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
spellingShingle Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
Barreto, Raissa Mont´Alverne
Avaliação em saúde
Atenção Primária à Saúde
Atenção à saúde
title_short Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
title_full Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
title_fullStr Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
title_full_unstemmed Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
title_sort Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB
author Barreto, Raissa Mont´Alverne
author_facet Barreto, Raissa Mont´Alverne
author_role author
dc.contributor.author.fl_str_mv Barreto, Raissa Mont´Alverne
dc.contributor.advisor1.fl_str_mv Albuquerque, Izabelle Mont'Alverne Napoleão
contributor_str_mv Albuquerque, Izabelle Mont'Alverne Napoleão
dc.subject.por.fl_str_mv Avaliação em saúde
Atenção Primária à Saúde
Atenção à saúde
topic Avaliação em saúde
Atenção Primária à Saúde
Atenção à saúde
description Primary Care has Family Health as a priority strategy for its organization, with indisputable advances, but there are still many problems that need to be addressed so that it can play its role as coordinator of health care. Thus, the need to carry out evaluative quality surveys of Primary Health Care emerges due to its capillarity of actions aimed at the majority of the population. The objective of this study was to evaluate the quality of Primary Care of the city of Sobral, Ceará within the dimensions Structure and Process, from the Donabedian referential. It is an evaluative research under the quantitative and qualitative approaches. For the collection of the quantitative data an adaptation of the Instrument of Evaluation of Basic Attention Services (QualiAB) with the managers and teams of health of the family, was inserted in a free software of web platform called LimeSurvey. For the qualitative data, semi-structured interviews were conducted with managers of the Units in order to collect information about the perception of these actors regarding the evaluation process and possible impacts resulting from this process. To analyze the qualitative data, a Bardin content analysis was performed with the support of the software N Vivo11, and for the analysis of the quantitative data the QualiABSobral tool was built, which was developed in a web platform and fed by importing the data inserted in the software used to collect the data. Simple descriptive statistics techniques were also used, from tabulation, data processing and table production by the Excel program. In general, for the structure dimension, good performance was observed, but it is worth emphasizing aspects that compromise this assistance, such as the fact that three Units are without a doctor and 50% of them present a smaller number of teams than the one recommended by PNAB, in high care demands. In addition, it was visualized the need for improvements in accessibility for people with disabilities; insufficient emergency and emergency equipment; absence of vehicle for use by the Unit; and deficiency in the availability of some drugs. For the process dimension, good results were observed, but it is necessary to reflect on the scheduling of the consultations; waiting time between referrals, specialist consultations and examinations; routine care of the child; greater emphasis on health care for man and the worker; and strategies to stimulate popular participation. The results of the interviews with the managers brought qualitative contributions and allowed identifying factors that deserve to be highlighted for the improvement of the quality of care, such as a greater valuation of the evaluation processes to contribute to the planning and management of the local health system in an efficient, and satisfactory; greater commitment between Primary Care and Health Care Networks to simplify and make effective the counterreference process in order to value the continuity of care; minimization of bureaucratic processes linked to management and simplification in filling spreadsheets to generate health indicators that are compatible between services. Thus, the results allow obtaining information essential to strategic decision making by managers and a broader picture of the actual situation of Sobral, besides contributing to the elaboration of a planning based on the needs and propositions of improvements for the qualification of the assistance rendered to the population of the studied municipality.
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-09-23T12:29:30Z
dc.date.available.fl_str_mv 2019-09-23T12:29:30Z
dc.date.issued.fl_str_mv 2019-05-29
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dc.identifier.citation.fl_str_mv BARRETO,R.M. Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB. 2019. 190 f. Dissertação (Mestrado em Saúde da Família) Campus Sobral, Universidade Federal do Ceará, Sobral,2019.
dc.identifier.uri.fl_str_mv http://www.repositorio.ufc.br/handle/riufc/46005
identifier_str_mv BARRETO,R.M. Avaliação da qualidade da Atenção Primária à Saúde no município de Sobral, Ceará a partir do QualiAB. 2019. 190 f. Dissertação (Mestrado em Saúde da Família) Campus Sobral, Universidade Federal do Ceará, Sobral,2019.
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