Primary health care indicators in four municipalities of the Sate of Rio de Janeiro, 2005: results of a domestic survey in the population

CL Szwarcwald trabalhou na pesquisa,metodologia, concep????o e reda????o do artigo. MHM Mendon??a, na metodologia, concep????o do artigo e revis??o cr??tica do texto. CLT de Andrade, na pesquisa, metodologia, concep????o do artigo, elabora????o de tabelas e revis??o cr??ticaO inqu??rito domiciliar de base populacional, realizado em quatro dos 22 munic??pios com mais de cem mil habitantes do Estado do Rio de Janeiro que implementaram o Projeto de Expans??o e Consolida????o do Sa??de da Fam??lia (Proesf), visa ?? institucionaliza????o da avalia????o e monitoramento da aten????o b??sica. Este estudo desenvolveu-se no contexto dos Estudos de Linha de Base (ELB) do Proesf. O instrumento utilizado ?? uma adapta????o do question??rio aplicado anteriormente em ??mbito nacional para avalia????o de desempenho de sa??de, sob a ??tica dos usu??rios. As altera????es voltaram-se para a avalia????o da aten????o b??sica, com foco no Programa de Sa??de da Fam??lia (PSF). Constru??ram-se indicadores de cobertura, qualidade de atendimento pr??-natal, assist??ncia ao parto, sa??de infantil, preven????o de c??ncer de colo uterino e mama, assist??ncia a idosos e sa??de bucal. Destacaram-se os resultados observados na preven????o de c??ncer de colo de ??tero, pelas elevadas coberturas de exame ginecol??gico no per??odo de tr??s anos, ficando evidente a fragilidade do sistema de sa??de em rela????o ao tempo de entrega do resultado do exame. Refor??a-se a import??ncia de avaliar a qualidade da aten????o b??sica recebida sob a ??tica do usu??rio, para o estabelecimento de metas e defini????o de prioridades.The domestic survey carried out in the population of four of the 22 municipalities with more than 100 thousand inhabitants of the State of Rio de Janeiro that implemented the PROESF aims at institutionalizing assessment and monitoring of primary health care. This study was developed in the context of the baseline studies of the PROESF. The tool used in this study is an adaptation of the questionnaire used before on national level for assessing the performance of the health care system from the viewpoint of the user. The adaptations made refer to assessment of basic care focusing the PSF. Indicators were constructed for covering the areas quality of pre-natal care, assisted delivery, child health, prevention of colon and breast cancer, care for the aged and oral health were constructed. The results found with respect to the prevention of colon cancer were outstanding due to the high number of gynecological examinations performed during the period of three years covered by the study. The time gap between the examinations and the receipt of the results however shows clearly the weakness of the system, indicating the urgent need for evaluating the quality of the provided primary care from the viewpoint of the users, in order to establish goals and define priorities