Abstract
OBJECTIVE: to evaluate the structure, process and results of the Capillary Blood Glucose Self-monitoring Program in a Brazilian city. METHOD: epidemiological, cross-sectional study. The methodological framework of Donabedian was used to construct indicators of structure, process and outcome. A random sample (n = 288) of users enrolled and 96 health professionals who worked in the program was studied. Two questionnaires were used that were constructed for this study, one for professionals and one for users, both containing data for the evaluation of structure, process and outcome. Anthropometric measures and laboratory results were collected by consulting the patients' health records. The analysis involved descriptive statistics. RESULTS: most of the professionals were not qualified to work in the program and were not knowledgeable about the set of criteria for patient registration. None of the patients received complete and correct orientations about the program and the percentage with skills to perform conducts autonomously was 10%. As regards the result indicators, 86.4% of the patients and 81.3% of the professionals evaluated the program positively. CONCLUSION: the evaluation indicators designed revealed that one of the main objectives of the program, self-care skills, has not been achieved.
Highlights
The assessment of health services, technologies and programs has been greatly stimulated in Brazil, for monitoring health professionals’ performance as well as for managers to make decisions about human resources and inputs in health, at the federal, state and municipal level.The National Performance Assessment Policy of the Unified Health System (SUS) indicates that health assessment permits the adoption of intervention measures in response to possible distortions, contradictions and difficulties met in the health services[1]
The PAMGC was implemented after the approval of Brazilian Federal Law 11.347 in 2006, making obligatory the supply of materials free of charge, such as glucometers, reactive strips for capillary glucose measures and digital puncture lancets, to type 1 (DM 1) and type 2 (DM 2) Diabetes Mellitus patients on insulin therapy for the purpose of self-monitoring at home[4]
Capillary glucose self-monitoring at home allows DM patients to develop skills with a view to autonomy and decision-making to achieve good glucose control measures, reduce acute and chronic complications and, improve their quality of life. This care technology is recommended as an essential part of the therapeutic strategies for adequate control of DM 1(5-6)
Summary
The assessment of health services, technologies and programs has been greatly stimulated in Brazil, for monitoring health professionals’ performance as well as for managers to make decisions about human resources and inputs in health, at the federal, state and municipal level.The National Performance Assessment Policy of the Unified Health System (SUS) indicates that health assessment permits the adoption of intervention measures in response to possible distortions, contradictions and difficulties met in the health services[1]. The assessment of health services, technologies and programs has been greatly stimulated in Brazil, for monitoring health professionals’ performance as well as for managers to make decisions about human resources and inputs in health, at the federal, state and municipal level. Among the ongoing health programs in Brazil, the Distribution Program of Glucometers and Inputs for SelfMonitoring of Capillary Glucose (PAMGC) for Diabetes Mellitus (DM) patients is highlighted. The PAMGC was implemented after the approval of Brazilian Federal Law 11.347 in 2006, making obligatory the supply of materials free of charge, such as glucometers, reactive strips for capillary glucose measures and digital puncture lancets, to type 1 (DM 1) and type 2 (DM 2) Diabetes Mellitus patients on insulin therapy for the purpose of self-monitoring at home[4]
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