The influence of structural and organizational factors on the performance of primary health care in Belo Horizonte, Minas Gerais State, Brazil, according to nurses and managers

The aim of this study was to evaluate the performance of primary health care (PHC) in Belo Horizonte, Minas Gerais State, Brazil, using the Portuguese-language version of the Primary Health Care Assessment Tool among nurses and managers of family health teams. Total PHC score was 0.75 (good). The dimensions first contact (0.95), longitudinality (0.83), comprehensiveness (0.83), and coordination (0.78) performed the best. Family approach, community orientation, and access received the lowest scores (0.68, 0.56, and 0.45, respectively). Better PHC performance was associated with the following factors (p < 0.05): availability of health care equipment and other inputs (adjusted PR = 1.57), education and training for family health teams (PR = 1.44), a physician on duty for more than 30 hours per week (PR = 1.42), and presence of four or more teams per primary care unit (PR = 1.09). The results show the importance of structural and organizational factors for PHC performance and suggest that permanent evaluation can identify aspects that require quality improvement.