User satisfaction in relation to Primary Health Care services in Brazil

Cantalino, Juliana Leal Ribeiro; Scherer, Magda Duarte dos Anjos; Soratto, Jacks; Schäfer, Antônio Augusto; Anjos, Davllyn Santos Oliveira dos

doi:10.11606/s1518-8787.2021055002533

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Original Article • Rev. Saúde Pública 55 • 2021 • https://doi.org/10.11606/s1518-8787.2021055002533 copy

User satisfaction in relation to Primary Health Care services in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To analyze user satisfaction in relation to access, infrastructure and quality of Primary Health Care (PHC) services in Brazil.

METHODS:

This cross-sectional study was conducted with data from 114,615 users linked to 30,523 health teams, obtained through the database of the Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB —National Program for the Improvement of Access and Quality of Primary Care). Independent variables related to access, infrastructure and quality of services in PHC were studied. The outcome, user satisfaction, was measured using the variables: “if given the option, I would change the staff or health service” and “I would recommend this health service to a friend or family member.” To assess satisfaction according to independent exposure variables, Pearson’s chi-squared test was used, considering a significance level of 5%. Descriptive analyses of the variables were performed using absolute (n) and relative (%) frequencies.

RESULTS:

User satisfaction was associated with the variables of access (p < 0.001), infrastructure (p < 0.001) and quality of services (p < 0.001) in PHC. The proximity of the service, attention to spontaneous demand, listening and the respect of professionals to the singularities of the patient, as well as the problem-solving capacity of the services, without the need for referrals to others and the good infrastructure, were related to user satisfaction.

CONCLUSION:

To ensure the improvement of the quality of services offered in PHC in Brazil, the aspects of user satisfaction identified in this study should be considered in the organization and management of services.

DESCRIPTORS
Primary Health Care; Patient Satisfaction; Health Evaluation; Health Services

Characteristics		n	%
Gender
	Male	23,412	20.4
	Female	91,203	79.6
Age group (years)
	≤ 29	27,479	24.0
	30–54	50,899	44.4
	55–64	18,771	16.4
	≥ 65	17,466	15.2
Race/skin color (n = 112,472)^ᵃ a Maximum percentage of unknown observations for the variable race/skin color: 2,143 (1.9%).
	White	41,145	36.6
	Black	15,010	13.3
	Brown/mixed	51,909	46.2
	Yellow	3,528	3.1
	Indigenous	880	0.8
Schooling
	Not literate (cannot read and write)	8,669	7.6
	Literate (can read and write)	8,491	7.4
	Some elementary school	41,213	36.0
	Elementary school	12,169	10.6
	Some high school	11,966	10.5
	High school	24,840	21.7
	Some higher education	3,078	2.7
	Higher education	4,045	3.5

		total n	If I had the option, I would change staff or health service					I would recommend the health service to a friend or family member
			Yes		No		p-valor	Yes		No		p
			n	%	n	%	p-valor	n	%	n	%	p
Time of commuting from home to the Health Service		114,195
	< 30 minutes		15,072	16.0	79,398	84.0	< 0.001	81,973	86.8	12,497	13.2	< 0.001
	≥ 30 minutes		5,093	25,8	14,632	74.2		16,297	82.6	3,428	17.4
Easy access to the Health Service		114,615
	Very easy/easy		13,568	14.7	78,523	85.3	< 0.001	80,541	87.5	11,550	12.5	< 0.001
	Reasonable/difficult and very difficult		6,668	29.6	15,856	70.4		18,076	80.3	4,448	19.7
Opening hours of the health service meet the needs		113,076
	Yes		13,374	13.6	84,824	86.4	< 0.001	87,976	89.6	10,222	10.4	< 0.001
	No		6,450	43.4	8,428	56.6		9,509	63.9	5,369	36.1
Quality of service when there is no scheduled time		67,277
	Very good/good		6,717	12.1	48,983	87.9	< 0.001	50,810	91.2	4,890	8.8	< 0.001
	Regular/bad/very bad		5,723	49.4	5,854	50.6		7,225	62.4	4,352	37.6

		total n	If I had the option, I would change staff or health service					I would recommend the health service to a friend or family member
			Yes		No		p	Yes		no		p
			total n	%	n	%	p	total n	%	n	%	p
The team seeks to solve the needs/problems in the Health Service itself		113,185
	Always/most of the time		13,887	13.7	87,799	86.3	< 0,001	91,122	89.6	10,564	10,4	< 0.001
	Hardly ever/never		6,037	52.5	5,462	47.5		6,362	55.3	5,137	44,7
Medical office is a reserved and private place	113,859
	Yes		17,338	16.1	90,375	83.9	< 0,001	94,181	87.4	13,532	12,6	< 0.001
	No		2,713	44.1	3,433	55.9		3,868	62.9	2,278	37,1
Professionals provide guidance on the need for rest, adequate nutrition and how to take medicines		113,409
	Always/most of the time		14,864	14.7	86,072	85.3	< 0,001	89,614	88.8	11,322	11,2	< 0.001
	Hardly ever/never		5,114	41.0	7,359	59.0		8,046	64.5	4,427	35,5
Feels respected by professionals in relation to cultural habits, customs, religion		113,777
	Always/most of the time		17,905	16.3	92,057	83.7	< 0,001	96,133	87.4	13,829	12,6	< 0.001
	Hardly ever/never		2079	54.5	1,736	45.5		1,896	49.7	1,919	50,3
Appointment with the doctor is sufficient		112,372
	Yes		11,864	12.7	81,275	87.3	<0,001	83,616	89.8	9,523	10,2	< 0.001
	No		7,854	40.8	11,379	59.2		13,230	68.8	6,003	31,2
Appointment with the nurse is sufficient		103,789
	Yes		13,525	14.3	81,281	85.7	< 0,001	84,159	88.8	10,647	11,2	< 0.001
	No		4,082	45.4	4,901	54.6		5,689	63.3	3,294	36,7
It is easy to talk to the professionals who treat you to ask questions after appointments		79,216
	Always/most of the time		8,062	12.3	57,404	87.7	< 0,001	59,452	90.8	6,014	9,2	< 0.001
	Hardly ever/never		6,073	44.2	7,677	55.8		8,766	63.8	4,984	36,2
Find it easy to talk to professionals about exam results		105,586
	Always/most of the time		11,089	13.0	74,363	87.0	< 0,001	76,967	90.1	8,485	9,9	< 0.001
	Hardly ever/never		7,424	36.9	12,710	63.1		14,022	69.6	6,112	30,4
Quality of care received by the health team		114,378
	Very good/good		9,381	10.0	84,876	90.0	< 0,001	87,284	92.6	6,973	7,4	< 0.001
	Regular/bad/very bad		10,780	53.6	9,341	46.4		11,205	55.7	8,916	44,3

		total n	If I had the option, I would change staff or health service					I would recommend the health service to a friend or family member
			Yes		No		p	Yes		No		p
			n	%	n	%	p	n	%	n	%	p
Health service facilities are in good condition for use		114,615
	Yes		10,164	11.9	75,038	88.1	< 0,001	77,241	90.7	7,961	9.3	< 0,001
	No		10,072	34.2	19,341	65.8		21,376	72.7	8,037	27.3
The facilities of the health service are in good cleaning condition		114,615
	Yes		13,526	13.8	84,460	86.2	< 0,001	87,562	89.4	10,424	10.6	< 0,001
	No		6,710	40.4	9,919	59.6		11,055	66.5	5,574	33.5
Enough chairs for people to sit in the waiting place		114,615
	Yes		6,265	10.2	55,390	89.8	< 0,001	56,449	91.6	5,206	8.4	< 0,001
	No		13,971	26.4	38,989	73.6		42,168	79.6	10,792	20.4
Perception of health service facilities		114,071
	Very good/good		6,278	8.6	66,958	91.4	< 0,001	67,891	92.7	5,345	7.3	< 0,001
	Regular/bad/very bad		13,860	33.9	26,975	66.1		30,297	74.2	10,538	25.8

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[1] Correspondence: Juliana Leal Ribeiro Cantalino Faculdade de Ciências da Saúde Campus Universitário Darcy Ribeiro, s/n Asa Norte 70910-900. Brasília, DF E-mail: juliana.lrc@gmail.com