Primary Care Information System Research Articles

[Estimation of prevalence of chronic Chagas disease in Brazilian municipalitiesEstimación de la prevalencia de la enfermedad de Chagas crónica en los municipios brasileños].

The objective of this study is to estimate the prevalence of chronic Chagas disease (CCD) in Brazil: in the general population, in women, and in women of childbearing age. A meta-analysis of the literature was conducted to extract data on the prevalence of CCD in municipalities in Brazil in the 2010-2022 period: in the general population, in women, and in women of childbearing age. Municipal-level CCD indicators available in health information systems were selected. Statistical modeling of the data extracted from the meta-analysis (based on data obtained from information systems) was applied to linear, generalized linear, and additive models. The five most appropriate models were selected from a total of 549 models tested to obtain a consensus model (adjusted R2 = 54%). The most important predictor was self-reported CCD in the primary health care information system. Zero prevalence was estimated in 1 792 (32%) of Brazil's 5 570 municipalities; in the remaining 3 778 municipalities, average prevalence of the disease was estimated at 3.25% (± 2.9%). The number of carriers of CCD was estimated for the Brazilian population (~3.7 million), for women (~2.1 million) and for women of childbearing age (~590 000). The disease reproduction rate was calculated at 1.0336. All estimates refer to the 2015-2016 period. The estimated prevalence of CCD, especially among women of childbearing age, highlights the challenge of vertical transmission in Brazilian municipalities. Mathematical projections suggest that these estimates should be included in the national program for the elimination of vertical transmission of Chagas disease.

Nonspecific Effects of the Bacillus Calmette-Guérin Vaccine in Portuguese Children Under 5 Years of Age: Protocol for a Population-Based Historical Birth Cohort Study.

The Bacillus Calmette-Guérin vaccine (BCG) against tuberculosis (TB) shows beneficial nonspecific effects, which are likely related to innate immune training. Until 2016, a single BCG dose was administered to all newborns in Portugal. In July 2016, a clinical guideline established that only children under 6 years belonging to high-risk groups should receive BCG. This might have prevented nonvaccinated children from developing trained immunological responses as effectively as BCG-vaccinated children. This study aims to investigate if there is variation in TB-related and all-cause mortality, and severe, moderate, or mild morbidity in children under 5 years of age, and whether such variation might be explained by the BCG vaccination policy change in 2016. This population-based historical birth cohort study includes children under 5 years of age born in Portugal between July 1, 2010, and June 30, 2021. Newborns with low birth weight, premature status, or known or suspected HIV infection are excluded. The follow-up period is until the completion of 5 years of age or the end of follow-up (June 30, 2021). The study will use secondary data from the National Health Service user registry, death certificate database, vaccination registry, communicable diseases surveillance system, TB surveillance system, diagnosis-related group information system for hospital admissions and emergency department visits, and primary health care information system. The data will be linked. Primary outcomes include person-time incidence rates of death (all causes and TB), TB diagnosis, and all causes and some specific causes of severe, moderate, or mild morbidity, and the incidence rate ratio of nonvaccinated to BCG-vaccinated children. We will compare the probability of surviving the first and fifth years of life or of not having severe, moderate, or mild morbidity during the follow-up period according to exposure (BCG vaccinated or nonvaccinated, number of doses, and time from birth until the first dose), using the log-rank test for assessing differences in survival rates between exposed and nonexposed children and hazard ratios for quantifying the differences. Moreover, we will perform a proportional hazards regression analysis. Ethics approval has been obtained. In March 2022, database owners were contacted to present the project and discuss the request for data. A unique identifier will be used. In July 2023, a process of redefinition of the variables per database was initiated. Data were received in October and November 2023. In November 2023, further work was conducted. By April 2024, we expect to start analyzing the full data set. The results will contribute to the accumulating body of knowledge and might have relevance to guide global BCG vaccination policy. Data linkage can contribute to a swifter mechanism to use available health data to conduct population-based studies and inform policy decision-making. ClinicalTrials.gov NCT05471167; https://clinicaltrials.gov/study/NCT05471167. DERR1-10.2196/55332.

[Evaluation of the impact of the implementation of the new primary health care information system on records of patient care and home visits in Brazil].

The replacement of the Primary Care Information System (SIAB, 1998-2015), as of January 2016, by the new Health Information System for Primary Care (SISAB) determined new forms of collecting, processing, and using information, with a possible impact on the records of activities carried out in primary health care in Brazil. This study aimed to evaluate the implementation impact of the new information system on records of physicians' and nurses' patient care and home visits of community health workers (CHW) in Brazil from 2007 to 2019. To this end, a Bayesian structural time-series model approach was used, based on a diffuse state-space regression. From 2016 to 2019, 463.47 million physician care, 210.61 million nursing care, and 1.28 billion CHW visits were recorded. Following the trend recorded before the implementation, 598.86 million, 430.46 million, and 1.5 billion physician and nursing appointments and CHW visits would be expected, respectively. In relative terms, there was a decrease of 25% in physician care, 51% in nursing care, and 15% in CHW visits when compared to the value expected by the Bayesian method. The negative impact on the records of patient care and home visits identified in this study, whether due to difficulties in adapting to the new system or a reduction in improper records, must be investigated so that the challenge of improving the primary care information system can be understood and overcome in a planned way.

A Pragmatic Mapping of Perceptions and Use of Digital Information Systems in Primary Care in Sweden: Survey Study.

Electronic health records and IT infrastructure in primary care allow for digital documentation and access to information, which can be used to guide evidence-based care and monitor patient safety and quality of care. Quality indicators specified by regulatory authorities can be automatically computed and presented to primary care staff. However, the implementation of digital information systems (DIS) in health care can be challenging, and understanding factors such as relative advantage, compatibility, complexity, trialability, and observability is needed to improve the success and rate of adoption and diffusion. This study aims to explore how DIS are used and perceived by health care professionals in primary care. This study used quantitative assessment to gather survey data on the use and potential of DIS in health care in Sweden from the perspectives of primary care personnel in various roles. The digital questionnaire was designed to be short and contained 3 sections covering respondent characteristics, current use of platforms, and perceptions of decision support tools. Data were analyzed using descriptive statistics, nonparametric hypothesis testing, ordinal coefficient α, and confirmatory factor analysis. The study collected responses from participants across 10 regions of Sweden, comprising 31.9% (n=22) from private clinics and 68.1% (n=47) from public clinics. Participants included administrators (18/69, 26.1%), a medical strategist (1/69, 1.4%), and physicians (50/69, 72.5%). Usage frequency varied as follows: 11.6% (n=8) used DIS weekly, 24.6% (n=17) monthly, 27.5% (n=19) a few times a year, 26.1% (n=18) very rarely, and 10.1% (n=7) lacked access. Administrators used DIS more frequently than physicians (P=.005). DIS use centered on quality improvement and identifying high-risk patients, with differences by role. Physicians were more inclined to use DIS out of curiosity (P=.01). Participants desired DIS for patient follow-up, lifestyle guidance, treatment suggestions, reminders, and shared decision-making. Administrators favored predictive analysis (P<.001), while physicians resisted immediate patient identification (P=.03). The 5 innovation attributes showed high internal consistency (α>.7). These factors explained 78.5% of questionnaire variance, relating to complexity, competitive advantage, compatibility, trialability, and observability. Factors 2, 3, and 4 predicted intention to use DIS, with factor 2 alone achieving the best accuracy (root-mean-square=0.513). Administrators and physicians exhibited role-based DIS use patterns highlighting the need for tailored approaches to promote DIS adoption. The study reveals a link between positive perceptions and intention to use DIS, emphasizing the significance of considering all factors for successful health care integration. The results suggest various directions for future studies. These include refining the trialability and observability questions for increased reliability and validity, investigating a larger sample with more specific target groups to improve generalization, and exploring the relevance of different groups' perspectives and needs in relation to decisions about and use of DIS.

From disease- to people-centred pandemic management: organized communities, community-oriented primary care and health information systems

BackgroundThe COVID-19 pandemic exposed the health equity gap between and within countries. Western countries were the first to receive vaccines and mortality was higher among socially deprived, minority and indigenous populations. Surprisingly, many sub-Saharan countries reported low excess mortalities. These countries share experiences with community organization and participation in health. The aim of this article was to analyse if and how this central role of people can promote a successful pandemic response.MethodsThis analysis was partly based on local and national experiences shared during an international and Latin American conference on person-and people-centred care in 2021. Additionally, excess mortality data and pandemic control-relevant data, as well as literature on the pandemic response of countries with an unexpected low excess mortality were consulted.ResultsTogo, Mongolia, Thailand and Kenya had a seven times lower mean excess mortality for 2020 and 2021 than the United States of America. More successful pandemic responses were observed in settings with experience in managing epidemics like Ebola and HIV, well-established community networks, a national philosophy of mutual aid, financial government assistance, more human resources for primary care and paid community health workers.DiscussionSince trust in authorities and health needs vary greatly, local strategies are needed to complement national and international pandemic responses. Three key levers were identified to promote locally-tailored pandemic management: well-organized communities, community-oriented primary care, and health information systems. An organized community structure stems from a shared ethical understanding of humanity as being interconnected with each other and the environment. This structure facilitates mutual aid and participation in decision making. Community-oriented primary care includes attention for collective community health and ways to improve health from its roots. A health information system supports collective health and health equity analysis by presenting health needs stratified for social deprivation, ethnicity, and community circumstances.ConclusionsThe difference in excess mortality between countries during the COVID-19 pandemic and various country experiences demonstrate the potential of the levers in promoting a more just and effective health emergency response. These same levers and strategies can promote more inclusive and socially just health systems.

Association between socioeconomic contextual factor, dental care service availability, and prevalence of periodontitis in Brazil: a multilevel analysis.

This study aimed to examine the effect of dental care services on periodontitis cases in Brazilian municipalities. The sample comprised 3,426 individuals aged 35-44 years. Moderate to severe periodontitis with clinical attachment loss and probing depth was the dependent variable, both > 3mm. Its exploratory variables were grouped into four categories: (1) individual characteristics; (2) contextual development indicators; (3) health service and structural factors; and (4) dental care use. Data were collected using the SBBrasil 2010 Project, the Brazilian Institute of Geography and Statistics, the Brazilian Information System of Primary and Secondary Care, and the Program to Improve Access and Quality of Dental Specialization Centers (PMAQ-CEO). Multilevel logistic regression was used to assess associations of periodontitis with individual and context variables. Municipalities with > 1 CEO or > 1 of any centers were associated with periodontitis, with OR = 0.97 (95%CI: 0.55-1.71) and OR = 0.41 (95%CI: 0.17-0.97), respectively. Prevalence of periodontitis was more likely in older people, lower education levels, and individuals that sought dental visits for pain/extraction and periodontal treatment. Other dental care services availability were not associated with the prevalence of periodontitis.

Zdravstveni kadrovi i reforma primarne zdravstvene zaštite u Crnoj Gori

Introduction: Universal health coverage reform activities in primary health care in Montenegro were conducted in the period between 2004 and 2012, with the aim of increasing the efficiency of the health care system by ensuring rational use and availability of resources. Aim: The purpose of this study is to describe the health personnel during and after the reform activities in Montenegro. Materials and methods: We adapted the four-dimensional World Health Organization framework to examine availability, accessibility, acceptability and quality of the health personnel in public primary health care facilities, in Montenegro, during and after the reform. Availability, accessibility, acceptability and quality of health personnel were examined using a defined set of proxies. In addition, the latest available data on density rates of health personnel were presented, in order to examine the sustainability of the implemented reforms. The data used included primary health care information system data, data published by the Institute of Public Health of Montenegro, as well as data from a number of official and expert reports by relevant experts and institutions. Results: The total number of physicians employed in primary health care was reduced during the reform by 5%, while the number of nurses was decreased by 35%. At the same time, the number of GPs (chosen doctors for adults) increased, which improved their availability (54.4 in 2015 vs. 36.3 in 2004, per 100,000). Accessibility showed great variations among municipalities. The utilization of health care services, at the national level, increased by 25% in adult health care services. The reduction of the number of nurses was tailored to meet set norms in health care services for adults, women, and children. Reform activities improved the professional competencies of primary health care teams. Conclusion: Primary health care reform improved the availability and accessibility of health personnel and implemented activities that improved their acceptability and quality. It is recommended to establish a permanent body which would continuously monitor the functioning of the primary health care (PHC) system, as well as the changes that occur in PHC, thus ensuring that reform results are maintained and further improved.

Description of deaths from cervical cancer in the population of Recife-PE, from 2019 to 2021

Cancer of the Uterus (UCC) is a disease that affects thousands of women worldwide, where, present the factor for the pathology, the presence of HPV viruses 16 and 18. The screening of UCC in Brazil is performed through the cytological exam, however, along with this and examination there are barriers that need to be overcome. It is identified that this neoplasm has a high incidence and prevalence in the Brazilian female population, especially in the State of Pernambuco in its capital Recife. Thence, in the State every day occurs a death as a result of UCC. So, to occur an organized screening of the and accurate to get diagnosis of where the women in the age group are for screening, focus on women of higher risk age group and who do not do the pathological cite examination. To verify the data for organized UCC screening, number of women in eligible age group, locality of residence and cytological coverage in the population of Recife-PE. This is an epidemiological cohort study with a cross-sectional, descriptive approach , with a quantitative approach, whose data were collected through the secondary database of the Primary Care Information System (SISAB/SUS), E-SUS AB, provided by DATASUS/Ministry of Health. The population consisted of women registered in the E-SUS AB, registered in the Health Units of the Health Districts (SD) in the city of Recife-PE, in the temporal cohort from the years 2019 to 2021. The results showed that in a total population of 481,453 women, 164,650 women underwent the preventive examination. That is not even 34% of the population. Deaths from UCC is predominant among the 40-49 years, with 26% of the population, between the years 2019-2021. Confirming 67 deaths in 2021, with predominance in the II, IV and VII District. That with the high number of incidence and deaths from UCC, the present study can raise awareness of women for the participation of screening, whether by the "Papanicolau" or by HPV-DNA, and thus contribute to the reduction of the incidence and deaths from UCC.

General practice database on mortality in adults on methylphenidate: cohort study

ObjectivesMethylphenidate is a ‘prescription only’ drug against attention disorders which is increasingly used by adults. We investigated whether methylphenidate in adults was associated with an increased risk of psychiatric events...

Prevalence and incidence of diabetes among Aboriginal people in remote communities of the Northern Territory, Australia: a retrospective, longitudinal data-linkage study

ObjectivesTo assess the prevalence and incidence of diabetes among Aboriginal peoples in remote communities of the Northern Territory (NT), Australia.DesignRetrospective cohort analysis of linked clinical and administrative data sets from...

Número de equipes assistenciais e internações por condições sensíveis à atenção primária

Abstract This study aimed to analyze the correlation between the number of health care teams of the Family Health Strategy (FHS) and the number of hospitalizations due to primary care sensitive conditions (HPCSC) taking into account rates, costs and hospital days in a large municipality of the state of Minas Gerais, Brazil, between 2010 and 2019. We performed an ecological time series correlation study on HPCSC of patients hospitalized by the public health system. Data were obtained from the Hospital Information System of the IT Department of the Public Health System (DATASUS) and from the Primary Care Information and Management System. The correlation analysis was performed based on the number, gross and standardized rates, percentages, costs and hospital days of HPCSC and health care coverage (average number of teams) using Spearman’s correlation coefficient at a significance level of 5% (p &lt; 0.05). No satisfactory correlation was found in the entire period between the increase in the number of health care teams and HPCSC (except for the standardized hospitalization rate). However, during the period in which the FHS coverage of the population was greater than 70%, all correlations were inversely proportional and statistically significant.

Effects of turnover and stability of health staff on quality of care in remote communities of the Northern Territory, Australia: a retrospective cohort study

ObjectivesTo evaluate the relationship between markers of staff employment stability and use of short-term healthcare workers with markers of quality of care. A secondary objective was to identify clinic-specific factors...

Cobertura de vacinação anti-influenza em idosos, Minas Gerais, Brasil

A influenza é uma infecção viral aguda, imunoprevenível, de transmissão causada por meio das secreções respiratórias de pessoa contaminada pelo vírus influenza.  Após a introdução da vacina de Influenza no calendário de vacinação do idoso foi possível notar a redução dos casos de pneumonias e de óbitos por complicações decorrentes da influenza. Tendo em vista a importância da vacinação para o idoso, este estudo objetivou analisar a cobertura vacinal anti-influenza em idosos em Minas Gerais (MG). Método: Trata-se de um estudo transversal, utilizando os dados da campanha de vacinação de 2017. Os dados foram coletados das bases do Sistema de Informação do Programa Nacional de Imunização – SIPNI, Sistema de Informação da Atenção Básica – SISAB e Instituto Brasileiro de Geografia e Estatística – IBGE. Resultados: A cobertura vacinal anti-influenza na Região Oeste foi de 95,6%. Entre os 53 municípios desta região, a maioria (84,9%) alcançou a meta de cobertura vacinal de influenza de 90%, conforme preconizado. O porte populacional e a cobertura de equipe de saúde da família dos municípios não estiveram associadas à cobertura vacinal, apresentando um p valor de 0,697 e 0,949, respectivamente. Conclusão: O estudo demonstrou alta cobertura vacinal em idosos em Região Oeste de MG e essa cobertura não foi influenciada pela presença de EFS e porte populacional dos municípios.

ANALYSIS OF THE DRESSING PRODUCTION RECORDS CARRIED OUT IN BRAZIL, 2017 – 2019

Objective: to analyze the record of dressings in the different Health Information Systems (Sistemas de Informação à Saúde-SIS). Method: it is a descriptive study, based on secondary data, in the period between 2017 and 2019. The data were extracted from open access systems and national coverage, among them: 1) Sistema de Gerenciamento da Tabela de Procedimentos, Medicamentos, Órteses, Próteses e Materiais Especiais-SIGTAP (Management System for the Table of Procedures, Drugs, Orthoses, Prostheses and Special Materials); 2) Sistema de Informação da Atenção Básica-SISAB (Primary Care Information System); 3) Sistema de Informação Ambulatorial-SIA/SUS (Ambulatory Information System). Results: 74,032,134 simple dressings were registered, of which 46.1% in 2017, 27.1% in 2018 and 26.7% in 2019. Regarding the grade II curative procedure with or without debridement, there were 11,559,664, with a value of approved of R$ 380,142,162.10. Of which 31.6% in 2017, 32.6% in 2018 and 35.8% in 2019. The name of the dressing procedure differs from Primary Care for the other levels of care, although in SISAB the dressings are called simple dressing and special dressing, both are related to the SIGTAP code: 0401010023 - Dressing Grade I. While in SIA/SUS the procedures related to dressing are 0401010023 - Dressing Grade I; and 0401010015 - Grade II dressing, making it difficult to compare procedures. In SIGTAP, the professional stoma nurse is qualified only to register a dressing 0401010023 - Grade I dressing, with or without debridement. Conclusion: the study reveals the need for revision of the SIS, due to inconsistencies of information, in addition to the SIS not communicating with each other. Thus, the completeness of the data needs to be considered, otherwise the knowledge generated may not represent reality.

Diagnosis of mucosal changes and hospitalized oral cancer patients in Brazil: influence of socioeconomic factors.

This study aimed to analyze the influence of socioeconomic factors on the frequency of diagnoses of oral mucosal changes and the number of hospitalized patients with oral and oropharyngeal cancer in Brazil. This cross-sectional study analyzed data from all Brazilian cities in the period 2011-2017. The frequency of diagnoses of oral mucosal changes and the number of hospitalized patients of oral and oropharyngeal cancer in Brazil were extracted from the Primary Care Information System (SIAB) and Brazilian National Cancer Institute (INCA) databases. The socioeconomic factors evaluated were the Gini coefficient of inequality, municipal Human Development Index (MHDI), inadequate basic sanitation rate, employment rate, illiteracy rate and expected years of schooling. Associated factors were examined using bivariate Spearman's correlations and multivariate Poisson regressions, and statistically significant (p < 0.05) correlations between study variables and regression coefficients were obtained. A higher frequency of diagnoses of mucosal changes was observed in cities with a higher Gini coefficient (B = 11.614; p < 0.001), higher MHDI (B = 11.298; p < 0.001), and higher number of hospitalized patients with oral and oropharyngeal cancer (B = 0.001, p < 0.002). Cities with higher Gini coefficients (B = 8.159, p < 0.001), higher inadequate basic sanitation rates (B = 0.09, p = 0.001), lower expected years of schooling (B = -0.718, p < 0.001), and higher illiteracy rates (B = 0.191, p < 0.001) had a higher frequency of hospitalized patients with oral and oropharyngeal cancer. In conclusion, more developed cities showed a higher frequency of diagnoses of mucosal changes. Greater inequality and worse socioeconomic conditions are associated with a higher frequency of hospitalized patients with oral and oropharyngeal cancer in Brazil.

Toward Integration of mHealth in Primary Care in the Netherlands: A Qualitative Analysis of Stakeholder Perspectives.

Background: There is a growing need to structurally change the way chronic illness care is organized as health systems struggle to meet the demand for chronic care. mHealth technologies can alter traditional approaches to health care provision by stimulating self-management of chronically ill patients. The aim of this study was to understand the complex environment related to the introduction of mHealth solutions into primary care for chronic disease management while considering health system functioning and stakeholder views.Methods: A transdisciplinary approach was used informed by the Interactive Learning and Action (ILA) methodology. Exploratory interviews (n = 5) were held with representatives of stakeholder groups to identify and position key stakeholders. Subsequently, professionals and chronically ill patients were consulted separately to elaborate on the barriers and facilitators in integration, using semi-structured interviews (n = 17) and a focus group (n = 6). Follow-up interviews (n = 5) were conducted to discuss initial findings of the stakeholder analysis.Results: Most stakeholders, in particular primary care practitioners and patients, seem to have a supporting or mixed attitude toward integration of mHealth. On the other hand, several powerful stakeholders, including primary care information system developers and medical specialists are likely to show resistance or a lack of initiative toward mHealth integration. Main barriers to mHealth integration were a lack of interoperability with existing information systems; difficulties in financing mHealth implementation; and limited readiness in general practices to change. Potential enablers of integration included co-design of mHealth solutions and incentives for pioneers.Conclusion: Stakeholders acknowledge the benefits of integrating mHealth in primary care. However, important barriers perceived by end-users prevent them to fully adopt and use mHealth. This study shows that the complexity of introducing mHealth into primary care calls for strategies encouraging collaboration between multiple stakeholders to enhance successful implementation.

Home visits in primary care: Differences among professional categories and health macro-regions.

Home visit is a modality of health care that is expanding in Brazil and in the world. Public and private services have invested in the implementation of this type of assistance. It happens due to its potential to transform the model of care, highlighting the work quality of the primary health care teams. To analyze house call rates in primary care in the Brazilian public healthcare system according to professional categories and health macro-regions in the state of Minas Gerais, southeast region of Brazil. An ecological study that used as the information source the production data from the Primary Care Information System (2010 to 2015). House call rates (per 3000 inhabitants) by primary care professionals constituted the response variable. The independent variables were professional categories and the 13 health macro-regions of the state. The data were analyzed using the Mann-Whitney test. A total of 26,932,463 house calls were performed in the period, but the number of visits in 2015 was significantly lower compared to 2010. Significantly higher house call rates were found for some professional categories (mid-level professionals and nurses) and significant differences were found among the macro-regions (P < 0.05). The profile of house calls by primary care professionals revealed the constant presence of this care modality, but the distribution of these visits is uneven among the different professional categories and macro-regions of the state.

Análise espaço-temporal das Infecções Respiratórias Agudas em crianças na Região de Saúde de Carajás, Pará

Objetivo: Descrever a distribuição espaço-temporal de Infecções Respiratórias Agudas (IRA) em crianças menores de dois anos em uma região do Pará.  Métodos: Trata-se de estudo transversal descritivo que utilizou como banco de dados secundário, o Sistema de Informação da Atenção Básica (SIAB). Foram coletados dados da região de saúde de Carajás, Pará, entre 2005 e 2015, acerca de crianças menores de dois anos. Os dados foram tabulados e analisados por estatísticas descritivas com o auxílio do software Tabwin, desenvolvido pelo Departamento de informática do Sistema Único de Saúde (DATASUS). Posteriormente os dados foram mapeados por meio do software Quantum GIS. Resultados: Foram registrados 149.459 casos de IRA em crianças menores de dois anos, com uma média de 13.587 casos por ano. Os meses de março e abril apresentaram as maiores médias mensais; 1368,72 casos/mês e 1278,63 casos/mês e os maiores registros absolutos de casos 15.056 e 14.065 respectivamente. Marabá (36.645) e Parauapebas (20.146) foram os municípios que mais registraram casos de IRA. Conclusão: Conclui-se que os municípios mais endêmicos necessitam de atenção especial quanto aos casos de IRA em crianças menores de 2 anos, sobretudo nos meses de inverno.

How data provided by the Brazilian information system of primary care have been used by researchers.

In this article, we have investigated how researchers use the data provided by the Brazilian Information System of Primary Care . We also searched, for the first time, studies that evaluated the quality and reliability of the information provided by the Primary Care Information System. An integrative review of the literature was performed using the keywords 'information systems, primary care and SIAB' on search databases, and 53 of 174 articles were selected. These publications were classified into two large subgroups: those using the Primary Care Information System as 'data source' and those that took it as the 'object of study'. The first group included 35 studies, 18 of which used demographic and social health data records, and nine described data about diseases, specifically hypertension and diabetes. These data were used by researchers for association with health indicators (20%) or comparison with other information systems (17%), sample or population calculus (9%), estimation of prevalence and characterization of the epidemiological profile of a population (26%) or, more generally, to carry out the assessment of health status (29%). The Primary Care Information System as the 'object of study' group included 18 works, describing the knowledge and practices of professionals in relation to the information system. These researchers pointed out issues in the process of production and information consolidation, mainly due to the lack of training and supervision of community health workers and bureaucratization of their work process. Although some issues in the quality of data provided by the Primary Care Information System were reported by researchers, these findings were not corroborated by two studies that assessed the reliability of information disclosed by this system. Despite changes in the Brazilian health policies, the issue of data quality in health information systems continues to be a challenge preventing data from being used for decision-making and knowledge production.

Cuadros de mando específicos de atención primaria como herramienta de gestión

IntroductionSpecific Scorecards are a key element to improve strategic lines aimed at enhancing intermediate health outcomes. Their implementation, involving professionals, requires identifying indicators linked to the outcomes of healthcare actions that the scientific literature may endorse. In addition, the inclusion of objectives that can be defined by parameterized by indicators of intermediate results in the health centre program contract, conveys the relevance of health actions and their impact on health. ObjectiveTo describe the design, development and outcomes of the specific scorecards of indicators of intermediate health outcomes in the Primary Care information system (eSOAP) in order to promote the involvement of professionals in strategic management from clinical management. MethodsPhase 1: description of the process (preparation and publication of 147 indicators, 46 of them of chronicity). Phase 2: observational descriptive study on the use of professionals and managers and data on the intermediate health outcomes obtained. ResultsA total of 268,849 reports were generated in 2017, with 35,835 reports of specific balanced scorecard (20%) being downloaded in just 6 months. One-quarter (25%) of the indicators of the Centre program contract are intermediate results. The percentage of diabetic patients controlled was 39.2%, and has improved significantly (P<.05) in 5 years. DiscussionThe specific scorecards with indicators of intermediate outcomes linked to strategic lines and their inclusion in the program contracts enables professionals to become involved in clinical and strategic management and improves the decision making of professionals and managers.