An evaluation of Primary Health Care from the users' perspective: reflections on the usage of the Primary Care Assessment Tool-Brazil in telephone surveys.

Abstract

To evaluate the attributes of PHC from the perspective of users, interviewed in a telephone survey in Belo Horizonte. Cross-sectional population-based study. Data from Vigitel 2015 that included an additional module on PHC assessment were used. A reduced version of PCATool-Brasil with adaptations was used. We interviewed 872 users and there was a predominance of women, older adults, adults with low levels of education, those without a partner, those who described themselves as brown, and those without health insurance. The overall score of the Vigitel assessment was 5.48 (95%CI 5.35 - 5.61) and the reduced PCATool was 5.01 (95%CI 4.86 - 5.15). In both instruments, the scores of the attributes first contact (utilization), longitudinality, and coordination (care) were higher than the general score with the highest value (5.48). The mean score of the first contact attribute (utilization) was the highest rated by users considering the Vigitel assessment instrument (7.09; 95%CI 6.93 - 7.26). In general, the evaluations of the instruments are coinciding, but the attributes first contact (utilization), completeness (available services) and coordination (information system) presented better mean scores in the Vigitel evaluation instrument when compared to the reduced PCATool. There was no difference in the evaluation according to Regional Health. The use of the reduced version of the PCATool in a telephone survey and with small adaptations to the local reality, showed a new possibility for the evaluation of PHC services, and may become useful in the management of health services.