Abstract
The National Program for Access and Quality Improvement in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, PMAQ-AB) aimed to improve healthcare public service quality and satisfaction of health service users. This study's objective was to identify the main factors influencing user satisfaction with primary care (PC) services by region in Brazil. Using secondary data from the 1st Cycle of PMAQ-AB, logistic regression models were developed by region, with user satisfaction as the dependent variable, as defined by cluster analysis. Based on the obtained models, the health unit's ability to solve users' problems and feeling respected by the health providers were the most important factors for user satisfaction in all regions in Brazil. However, other important factors by region included the following: the health unit's hours of operation meeting the user's needs (Northeast); providers asking about family members (North); providers asking about other health needs (Midwest); users being seen without an appointment (South); and users asking questions after the appointment (Southeast). In conclusion, the factors influencing user satisfaction with PC vary according to region and are mainly associated with access quality, meeting users' needs, and work process organization.
Highlights
There is clear evidence that national health systems that prioritize primary actions as the organizing axis of health practices achieve better health indicators, lower costs, and greater user satisfaction[1]
Other important factors by region included the following: the health unit’s hours of operation meeting the user’s needs (Northeast); providers asking about family members (North); providers asking about other health needs (Midwest); users being seen without an appointment (South); and users asking questions after the appointment (Southeast)
The most recent health assessment program conducted in Brazil is the National Program for Access and Quality Improvement in Primary Care (Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica, PMAQ-AB), which aims, among other things, to improve healthcare services according to user need and satisfaction
Summary
There is clear evidence that national health systems that prioritize primary actions as the organizing axis of health practices achieve better health indicators, lower costs, and greater user satisfaction[1]. PMAQ-AB has a phase called External Evaluation that evaluates the access to and quality of the health services in the municipalities and in the teams registered in the program through monitoring of contracted indicators and assessment of the teams’ quality standards. In this evaluation, one of the questions raised was user satisfaction and perception of the Primary Health Care (PHC) services in regard to access and usage[2]. Obtaining a statistically based evaluation of the interaction between health services and their users may contribute to the development of joint alternatives for more adequate interventions to solve daily routine problems with the services, favoring advances in health service production and management[5]
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