How Brazilians access Primary Health Care: evolution and adversities in recent times (2012-2018)

Abstract

The scope of this study is to analyze access to primary care in Brazil between 2012 and 2018, taking into consideration the availability of services and the physical-structural, temporal and organizational characteristics of the primary care units and teams, highlighting the main advances and obstacles to their enhancement in different contexts. It involved a descriptive cross-sectional and longitudinal study, with a quantitative approach based on secondary data from the National Program for the Improvement of Access and Quality of PC and population coverage data from the Ministry of Health. A total of 15,378 teams were selected and data screened from 59,354 users relating to the teams selected for 2012, and 56,369 users for 2018. Improvements were noted with respect to service availability and in terms of physical and architectural structure; the majority of the teams implemented and/or qualified the reception to spontaneous demand, including emergency care, improved the ways of organizing the agenda to foster a more integrated contact between users and health professionals and qualified the ways of scheduling and reduced the waiting times between scheduling and care. However, the persistence of recurring problems that need to be addressed to improve access to primary care in the country was detected.