Factors associated with the evaluation of Primary Health Care from the user’s perspective: results of the telephone survey Vigitel, 2015

Perillo, Rosângela Durso; Poças, Kátia Crestine; Bernal, Regina Tomie Ivata; Duarte, Elisabeth Carmen; Malta, Deborah Carvalho

doi:10.1590/1413-81232021263.45722020

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FREE THEMES • Ciênc. saúde coletiva 26 (3) • Mar 2021 • https://doi.org/10.1590/1413-81232021263.45722020 copy

Factors associated with the evaluation of Primary Health Care from the user’s perspective: results of the telephone survey Vigitel, 2015

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Abstract

This paper aims to evaluate the performance of PHC from the perspective of users and its association with sociodemographic characteristics, self-reported health conditions, and behavioral risk factors for Chronic Noncommunicable Diseases. This is a population-based cross-sectional study with data from the 2015 VIGITEL Telephone Survey. The Primary Care Assessment Tool short version was adopted. The study population covers adults over 18 years of age who used PHC services in Belo Horizonte in the last 12 months (n = 872). The multiple logistic regression model was performed to estimate the odds ratio. We observed that adults without a health insurance plan are 3.21 (95% CI 2.08-4.96) more likely than those with a health insurance plan to evaluate PHC with a high score (≥ 6.6), and adults with low schooling (95% CI 1.48-5.32), people with diabetes (95% CI 1.05-3.24), obese (95% CI 1.20-3.24), and older adults (95% CI 1.00-1.41) were 2.81, 1.84, 1.97, and 1.19 more likely to report a high score for PHC quality than the others, respectively. The use of the PCATool short version in a telephone survey showed a new possibility for PHC performance assessment and can become useful in managing health services.

Key words
Primary Health Care; Health services assessment; Health surveillance by telephone survey

Escore	Cálculo	Descrição
Standardized general score	(score-minimum score)*10 maximum score-minimum score	(1) if standardized general score ≥ 6.6 (0) if standardized general score < 6.6
General score	A+B+C+D+E+F+G+H+I 9	Sum of the degree of affiliation plus mean score of the components of the essential and derived attributes, divided by the total number of components
Essential score	A+B+C+D+E+F+G 7	Sum of the degree of affiliation plus mean score between the components of the attributes first contact (B), longitudinality (C), coordination (D and E) and comprehensiveness available (F), of the services provided (G), added to the degree of affiliation (A)
Derived score	H+I 2	Sum of the mean of the attributes family approach (H) and community orientation (I)
Score by attribute	After consolidating the relative data of each attribute, the values are transformed on a continuous scale, ranging from zero (0) to ten (10) given by the expression [score obtained - 1 (minimum value)] X 10/4 (maximum value) - 1 (minimum value)	(A) affiliation (B) use (C) attendance (D) care coordination (E) information coordination (F) comprehensiveness available (G) comprehensiveness provided (H) family approach (I) community orientation

Variables	Score ≥6,6^a n= 171			Score <6,6^b n= 701			P-value^d
Variables	%^c	CI 95%^d		%^c	CI95%^d		P-value^d
Gender							0.225
Male	23.27	17.77	29.85	76.73	70.15	82.23
Female	18.96	15.44	23.07	81.04	76.93	84.56
Age group (years)							0.181
18-29	14.26	8.30	23.42	85.74	76.58	91.70
30-39	18.08	11.27	27.73	81.92	72.27	88.73
40-59	22.00	16.75	28.34	78.00	71.66	83.25
60 and over	24.86	19.80	30.70	75.14	69.30	80.20
Schooling (years of study)							0.001
12 and over	10.71	6.45	17.26	89.29	82.74	93.55
9-11	18.83	14.27	24.42	81.17	75.58	85.73
0-8	27.08	21.72	33.20	72.92	66.80	78.28
Ethnicity/skin color*							0.349
White	18.89	14.17	24.73	81.11	75.27	85.83
Black	18.77	11.96	28.21	81.23	71.79	88.04
Yellow	11.04	3.16	32.05	88.96	67.95	96.84
Brown	23.95	18.94	29.81	76.05	70.19	81.06
Indigenous	8.90	1.17	44.67	91.10	55.33	98.83
Marital status							0.199
With partner	22.47	18.25	27.34	77.53	72.66	81.75
Without partner	18.18	14.01	23.27	81.82	76.73	85.99
Health insurance plan							0.000
Yes	11.07	8.04	15.06	88.93	84.94	91.96
No	28.85	23.96	34.28	71.15	65.72	76.04

Variables	Score >=6,6^a n= 171			Score <6,6^b n= 701			P-value^d
Variables	%^c	CI 95%^d		%^c	CI95%^d		P-value^d
Tobacco use							0.143
Yes	29.98	17.22	46.85	70.02	53.15	82.78
No	19.72	16.64	23.22	80.28	76.78	83.36
Alcohol abuse							0.396
Yes	16.24	8.51	28.77	83.76	71.23	91.49
No	21.22	17.96	24.89	78.78	75.11	82.04
Arterial Hypertension							0.009
Yes	26.59	21.33	32.60	73.41	67.40	78.67
No	17.60	13.96	21.94	82.40	78.05	86.04
Diabetes							0.007
Yes	32.94	23.11	44.52	67.06	55.48	76.89
No	19.07	15.88	22.72	80.93	77.28	84.12
Obesity							0.003
Yes	31.23	23.16	40.64	68.77	59.36	76.84
No	18.44	15.21	22.18	81.56	77.82	84.79

Variables	Crude model				Adjusted model
Variables	OR^a (crude)	CI^b (95%)		p-value^c	OR^d (ajusted)	CI^b (95%)		p-value^c
Gender ^e
Male	1.00				1.00
Female	0.77	0.51	1.17	0.226	0.77	0.51	1.18	0.236
Age group (years)^f
18-29	1.00				1.00
30-39	1.33	0.58	3.02	0.499	1.37	0.60	3.13	0.461
40-59	1.19	0.95	1.50	0.137	1.20	0.95	1.52	0.125
60 and over	1.19	1.00	1.41	0.046	1.19	1.00	1.41	0.048
Schooling (years of study)
12 and over	1.00				1.00
9-11	1.93	1.01	3.69	0.045	2.00	1.03	3.89	0.042
0-8	3.10	1.66	5.79	0.000	2.81	1.48	5.32	0.002
Ethnicity/skin color ^f
White	1.00				1.00
Black	1.03	0.55	1.91	0.936	1.10	0.58	2.07	0.775
Yellow	0.55	0.14	2.18	0.395	0.66	0.17	2.59	0.549
Brown	1.40	0.90	2.18	0.137	1.42	0.91	2.21	0.126
Indigenous	0.43	0.05	3.67	0.443	0.42	0.05	3.69	0.435
Marital status
With partner	1.00				1.00
Without partner	1.26	0.84	1.89	0.265	1.03	0.64	1.66	0.894
Health insurance plan
Yes	1.00				1.00
No	3.26	2.11	5.03	0.000	3.21	2.08	4.96	0.000
Tobacco use
No	1.00				1.00
Yes	1.74	0.82	3.69	0.147	1.69	0.80	3.56	0.169
Alcohol abuse
No	1.00				1.00
Yes	0.72	0.34	1.54	0.397	0.71	0.33	1.52	0.378
Arterial Hypertension
No	1.00				1.00
Yes	1.70	1.14	2.53	0.010	1.49	0.93	2.40	0.095
Diabetes
No	1.00				1.00
Yes	2.08	1.22	3.57	0.008	1.84	1.05	3.24	0.034
Obesity
No	1.00				1.00
Yes	2.04	1.28	3.27	0.003	1.97	1.20	3.24	0.007

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[1] Collaborations

RD Perillo and DC Malta worked on the study design, the writing of the paper, the analysis and interpretation of data, the literature review, and the final review of the text. RTI Bernal and KC Poças participated in the design of the study, in the analysis and interpretation of data, and the final review of the text. EC Duarte participated in the design of the study and the final review of the text. All authors approved the final version.