Reasons for encounter in primary health care in Brazil

Author:

Chueiri Patricia S1,Gonçalves Marcelo Rodrigues2,Hauser Lisiane3,Wollmann Lucas4,Mengue Sotero Serrate23,Roman Rudi23,Rodrigues Agostinho Rech Milena5,Soares Marcelo de Araújo Vianna2,Pertile Jamily2,Harzheim Erno26

Affiliation:

1. School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo

2. School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre

3. Postgraduate Program in Epidemiology, TelessaudeRS, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre

4. Community Health Services, Grupo Hospitalar Conceição, Porto Alegre

5. School of Medicine, Universidade de Caxias do Sul, Caxias do Sul

6. Secretary of Primary Health Care, Ministry of Health, Brasília, Brazil

Abstract

Abstract Background Primary health care (PHC) delivery in Brazil has improved in the last decades. However, it remains unknown whether the Family Health Strategy teams are meeting the health needs of the population. Objectives To describe the reasons for encounter (RFEs) in PHC in Brazil and to examine variations in RFEs according to sex, age and geographic region. Methods This descriptive study is part of a national cross-sectional study conducted in 2016. The sample was stratified by the number of PHC physicians per geographic region. Physicians who had been working for at least 1 year in the same PHC unit were included. For every participating physician, 12 patients aged ≥18 years who had attended at least two encounters were included. Patients were asked about their RFEs, which were classified according to the International Classification of Primary Care. Results In 6160 encounters, a total of 8046 RFEs were coded. Seven reasons accounted for 50% of all RFEs. There was a high frequency of codes related to test results, medication renewal and preventive medicine. RFEs did not vary significantly by sex or geographic region, but they did by age group (P < 0.001). The rates of prescriptions, requests for investigations and referrals to specialized care were 71.1%, 42.8%, and 21.3%, respectively. Conclusion This novel study opened the ‘black box’ of RFEs in PHC in Brazil. These findings can contribute to redefining the scope of PHC services and reorienting work practices in order to improve the quality of PHC in Brazil.

Funder

Pan American Health Organization

Publisher

Oxford University Press (OUP)

Subject

Family Practice

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