Abstract
ABSTRACTOBJECTIVETo evaluate whether the scheduling model influences the perception of the user about the quality of primary health care centers.METHODSThis is a cross-sectional and population-based study that measured the quality of centers by the Primary Care Assessment Tool (PCATool-Brazil), applied to adult users (n = 409) from 11 health centers in Florianópolis, state of Santa Catarina. Multilevel analysis was used to verify the relationship between the score of general quality of the primary health care and the scheduling model. The independent variables (age, skin color, scheduling model, panel size by primary health team, poverty ratio as income proxy, number of health teams, presence of economically interest areas, number of medical appointments in one year per primary health team, number of people treated in one year per health team), with p < 0.20 were selected for the multilevel model, which was adjusted with aggregates of information from users and health centers.RESULTSThe health center that used advanced access had a general score of 7.04, while those using a weekly carve-out had a score of 6.26; the carve-out every 15 days, score of 5.87; and the traditional carve-out, score of 6.29.CONCLUSIONSThe scheduling model of advanced access had a positive effect on the quality of primary health care, in the perception of users.
Highlights
The access, primary attribute of the quality in health care – access to structures and care processes in a timely manner, receiving effective care1 – directly influences the quality of primary health care (PHC).In the last ten years, there has been a significant increase in population coverage by the PHC, mainly by the Family Health Strategy model (Estratégia Saúde da Família)
The scheduling model of advanced access had a positive effect on the quality of primary health care, in the perception of users
Organizational changes are needed to address the issue of long delay in scheduling an appointment at PHC, which represents the inability of health centers to provide timely access and leads to avoidable negative experiences for users
Summary
The access, primary attribute of the quality in health care – access to structures and care processes in a timely manner, receiving effective care1 – directly influences the quality of primary health care (PHC).In the last ten years, there has been a significant increase in population coverage by the PHC, mainly by the Family Health Strategy model (Estratégia Saúde da Família). The greater availability of PHC centers did not result in an expressive improvement that ensured universal and equitable health coverage[2]. Organizational changes are needed to address the issue of long delay in scheduling an appointment at PHC, which represents the inability of health centers to provide timely access and leads to avoidable negative experiences for users. The uncertainty about being seen or not causes distress, especially among those who believe that their health condition is progressively worsening. It contributes to the increase in the inappropriate use of emergency services[3]
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