Abstract
ABSTRACTOBJECTIVE To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil.METHODS A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme. The responses indicate the service performance in older adults’ care, clustered into three areas of analysis: health care for active and healthy aging (45 indicators, d1), chronic noncommunicable diseases care (89 indicators, d2), and support network in aging care (21 indicators, d3). Performance was measured by the sum of positive (value 1) or negative (value 0) responses for each indicator. Services were clustered according to k-means of the performance scores of each domain. After weighting the domains (Z tests), we estimated the associations between the scores of each domain and independent management variables (typology, planning and evaluation of services), with simple and multiple linear regression.RESULTS Chronic noncommunicable diseases care (d2) showed, for all clusters, better average performance (55.7) than domains d1 (35.4) and d3 (39.2). Service performance in the general area of planning and evaluation associates with the performance of older adults’ care.CONCLUSIONS The evaluated services had incipient implementation of comprehensive care for older adults. The evaluation framework can contribute to processes to improve the quality of primary health care.
Highlights
Primary health care (PHC) is pointed out as a priority to assist and monitor older adults’ health status, besides acting in the prevention of health problems and in the health promotion to a healthy aging
The evaluation framework can contribute to processes to improve the quality of primary health care
This study aims to evaluate the performance of comprehensive care for older adults in primary health care services according to their managers and professionals, as well as to analyze the relationship between performance and indicators of health planning and evaluation
Summary
Primary health care (PHC) is pointed out as a priority to assist and monitor older adults’ health status, besides acting in the prevention of health problems and in the health promotion to a healthy aging. Since the last decade, evaluation and monitoring strategies are essential tools to measure the effectiveness of health systems at all levels of care[4]. In this context, evaluating services for the older adults’ health care, especially in PHC, is increasingly important to know the advances in implementing the recommendations of the Primary Care Guide no. They cover promotion and prevention actions to achieve active and healthy aging, management of chronic noncommunicable diseases (CNCD) and networking
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