Atenção às condições crônicas tendo o Diabetes Mellitus como condição traçadora: uma pesquisa avaliativa dos Serviços da Atenção Primária à Saúde de um município do interior de São Paulo
Carregando...
Data
2018-08-31
Autores
Silva, Daniela Cristina da
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
Nas últimas décadas, a transição demográfica e epidemiológica conduziu a um acelerado envelhecimento absoluto e relativo da população e, consequentemente, ao crescimento das Doenças Crônicas Não Transmissíveis, dentre as quais se destaca o Diabetes Mellitus (DM), com cerca de meio bilhão de casos em todo mundo. Esta situação, de expansão das condições crônicas de saúde determina uma revisão da abordagem dos problemas sanitários, seja na compreensão de seus determinantes seja na identificação e acompanhamento dos casos, na perspectiva dos cuidados de longo prazo, de forma participativa, familiar e multiprofissional. O DM é uma doença insidiosa, com frequentes complicações clínicas e repercussões, inclusive considerando sua alta prevalência e os impactos na vida das pessoas, a exemplo das incapacidades e mortalidade prematura. Este estudo objetivou avaliar a atenção às condições crônicas de saúde a partir do cuidado prestado aos usuários que vivem com Diabetes Mellitus, como condição traçadora no âmbito da Atenção Primária à Saúde. Do ponto de vista metodológico, trata-se de um estudo de caso, caracterizado como uma pesquisa avaliativa, quantitativa, transversal, baseada em levantamento de dados de múltiplas fontes, voltado à avaliação de serviços de saúde. A pesquisa utilizou dados primários e secundários dos atendimentos realizados pelos serviços na Atenção Primária em Saúde, no período de janeiro de 2015 a dezembro de 2017. A avaliação de estrutura, processo e resultados, proposta por Donabedian, foi utilizada como referencial teórico metodológico. Os resultados revelaram a existência de 6964 indivíduos que durante o ano de 2016, utilizaram a rebe básica de serviços de saúde do Município de Botucatu/SP para tratamento de DM, seja em atendimentos seja no acesso a medicamentos. Observou-se a escassez de atividades de promoção e prevenção, sendo a atenção focada no profissional médico com maior prevalência de consultas espontâneas; baixa cobertura e concentração do conjunto de exames complementares indicados para o DM; deficiência e irregularidade de retirada de medicações, por parte dos usuários. Conclui-se que a qualidade da atenção é insatisfatória, relacionada a importantes fragilidades principalmente no componente processo da atenção prestada.
In the last decades, the demographic and epidemiological transition has led to an accelerated absolute and relative aging of the population and, consequently, to the growth of Noncommunicable Chronic Diseases, among which Diabetes Mellitus (DM), with about half a billion cases worldwide. This situation of expansion of chronic health conditions determines a revision of the approach to health problems, either in the understanding of its determinants or in the identification and follow-up of cases, in the perspective of long-term care, in a participatory, family and multiprofessional way. DM is an insidious disease, with frequent clinical complications and repercussions, including considering its high prevalence and impacts on people's lives, such as disabilities and premature mortality. This study aimed to evaluate the attention to chronic health conditions from the care provided to users living with Diabetes Mellitus, as a tracing condition in Primary Health Care. From the methodological point of view, this is a case study, characterized as an evaluative, quantitative, cross-sectional research, based on data collection from multiple sources, aimed at the evaluation of health services. The research used primary and secondary data from the services performed by services in Primary Health Care, from January 2015 to December 2017. The evaluation of structure, process and results, proposed by Donabedian, was used as methodological theoretical reference. The results revealed the existence of 6964 individuals who during the year 2016 used the basic health services rebe of the Municipality of Botucatu / SP for the treatment of DM, both in care and in access to medication. The lack of promotion and prevention activities was observed, focusing attention on the medical professional with a higher prevalence of spontaneous consultations; low coverage and concentration of the set of complementary tests indicated for DM; deficiency and irregularity of medication withdrawal, by the users. It is concluded that the quality of care is unsatisfactory, related to important weaknesses mainly in the process component of care provided.
In the last decades, the demographic and epidemiological transition has led to an accelerated absolute and relative aging of the population and, consequently, to the growth of Noncommunicable Chronic Diseases, among which Diabetes Mellitus (DM), with about half a billion cases worldwide. This situation of expansion of chronic health conditions determines a revision of the approach to health problems, either in the understanding of its determinants or in the identification and follow-up of cases, in the perspective of long-term care, in a participatory, family and multiprofessional way. DM is an insidious disease, with frequent clinical complications and repercussions, including considering its high prevalence and impacts on people's lives, such as disabilities and premature mortality. This study aimed to evaluate the attention to chronic health conditions from the care provided to users living with Diabetes Mellitus, as a tracing condition in Primary Health Care. From the methodological point of view, this is a case study, characterized as an evaluative, quantitative, cross-sectional research, based on data collection from multiple sources, aimed at the evaluation of health services. The research used primary and secondary data from the services performed by services in Primary Health Care, from January 2015 to December 2017. The evaluation of structure, process and results, proposed by Donabedian, was used as methodological theoretical reference. The results revealed the existence of 6964 individuals who during the year 2016 used the basic health services rebe of the Municipality of Botucatu / SP for the treatment of DM, both in care and in access to medication. The lack of promotion and prevention activities was observed, focusing attention on the medical professional with a higher prevalence of spontaneous consultations; low coverage and concentration of the set of complementary tests indicated for DM; deficiency and irregularity of medication withdrawal, by the users. It is concluded that the quality of care is unsatisfactory, related to important weaknesses mainly in the process component of care provided.
Descrição
Palavras-chave
Diabetes Mellitus, Atenção Primária à Saúde, Avaliação de processos e resultados (cuidados de saúde), Sistema Único de Saúde., , Primary Health Care, Evaluation of processes and results (health care)