Continuity of primary care in the brazilian amazon: A cross-sectional population-based study

被引:3
作者
Galvao, Tais Freire [1 ]
Baldin Tiguman, Gustavo Magno [1 ]
Nunes, Bruno Pereira [2 ]
Correia da Silva, Andrea Tenorio [3 ,4 ]
Silva, Marcus Tolentino [5 ]
机构
[1] Univ Estadual Campinas, Fac Pharmaceut Sci, Campinas, Brazil
[2] Univ Fed Pelotas, Dept Publ Hlth Nursing, Pelotas, RS, Brazil
[3] Univ Sao Paulo, Dept Prevent Med, Sao Paulo, Brazil
[4] Fac Med Santa Marcelina, Primary Care Res Grp, Sao Paulo, Brazil
[5] Univ Sorocaba, Postgrad Program Pharmaceut Sci, Sorocaba, Brazil
关键词
Brazil; continuity of patient care; cross-sectional studies; health services; primary health care; UNIVERSAL HEALTH COVERAGE; ALMA-ATA; REBIRTH;
D O I
10.4103/ijpvm.IJPVM_440_19
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Few studies have evaluated the continuity of primary care in universal health care systems, especially in underserved areas. Methods: This was a cross-sectional study with 4,001 adults (>= 18 years old) living in the Manaus Metropolitan Region in 2015. Interviews were conducted in households selected with probabilistic sampling. City and neighborhood variables were collected from databanks. Prevalence ratios (PR) of the continuity of care (defined as using a primary care service and having been previously registered in the Family Health Strategy program) and 95% confidence intervals (CIs) were calculated with multilevel Poisson regression analysis. Results: A total of 20.6% (95%CI 19.4-21.9%) of the participants reported continuity of primary care. Women (PR = 1.38; 95%CI 1.18-1.61), nonwhite individuals (PR = 1.13; 95%CI 1.05-1.21), and poorer people (PR = 1.55; 95%CI 1.19-2.02) had higher levels of continuity, whereas health insurance holders had lower levels of continuity (PR = 0.46; 95%CI 0.34-0.62). Individuals with continuity of care had more physician consultations (PR = 1.06; 95%CI 1.02-1.10), dentist consultations (PR = 1.16; 95%CI 1.05-1.28), fewer depressive (PR = 0.59; 95%CI 0.44-0.79) and anxiety symptoms (PR = 0.64; 95%CI 0.48-0.85), and a higher quality of life (beta = 0.033; 95%CI 0.011-0.054) than those without continuity. Conclusions: Continuity of care was attained by two-tenths of the population and the level of continuity was high among socioeconomically disadvantaged people. Good outcomes and health services usage increased with continuity of care.
引用
收藏
页数:6
相关论文
共 17 条
[1]  
[Anonymous], 2015, CRIT CLASS EC BRAS 2
[2]   Alma-Ata: Rebirth and revision 3 - Improving the prevention and management of chronic disease in low-income and middle-income countries: a priority for primary health care [J].
Beaglehole, Robert ;
Epping-Jordan, JoAnne ;
Patel, Vikram ;
Chopra, Mickey ;
Ebrahim, Shah ;
Kidd, Michael ;
Haines, Andy .
LANCET, 2008, 372 (9642) :940-949
[3]  
Brasil. Ministerio da Saude, 2018, DEP INF SUST UN SAUD
[4]   Austerity threatens universal health coverage in Brazil [J].
Doniec, Katarzyna ;
Dall'Alba, Rafael ;
King, Lawrence .
LANCET, 2016, 388 (10047) :867-868
[5]   Reviewing the Brazilian National Primary Healthcare Policy at such a time? [J].
Guimaraes Cardoso Morosini, Marcia Valeria ;
Fonseca, Angelica Ferreira .
CADERNOS DE SAUDE PUBLICA, 2017, 33 (01)
[6]   Predictors of relational continuity in primary care: patient, provider and practice factors [J].
Kristjansson, Elizabeth ;
Hogg, William ;
Dahrouge, Simone ;
Tuna, Meltem ;
Mayo-Bruinsma, Liesha ;
Gebremichael, Goshu .
BMC FAMILY PRACTICE, 2013, 14
[7]   Relationship between Longitudinal Continuity of Primary Care and Likelihood of Death: Analysis of National Insurance Data [J].
Leleu, Henri ;
Minvielle, Etienne .
PLOS ONE, 2013, 8 (08)
[8]   An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS) [J].
Marten, Robert ;
McIntyre, Diane ;
Travassos, Claudia ;
Shishkin, Sergey ;
Longde, Wang ;
Reddy, Srinath ;
Vega, Jeanette .
LANCET, 2014, 384 (9960) :2164-2171
[9]   Health in Brazil 1 The Brazilian health system: history, advances, and challenges [J].
Paim, Jairnilson ;
Travassos, Claudia ;
Almeida, Celia ;
Bahia, Ligia ;
Macinko, James .
LANCET, 2011, 377 (9779) :1778-1797
[10]   The Citizen Constitution and the 25th anniversary of the Brazilian Unified National Health System (SUS) [J].
Paim, Jairnilson Silva .
CADERNOS DE SAUDE PUBLICA, 2013, 29 (10) :1927-1936