Desempenho das equipes de saúde com e sem adesão ao Programa Mais Médicos com base na avaliação de desempenho do programa de melhoria do acesso e da qualidade da atenção básica na região norte do Brasil

Abstract

The public health consolidates as a human right that must be guaranteed to the population regardless of political and / or economic factors. Among the main obstacles to the access and the quality of health in Brazil is the scarcity of health professionals, especially in geographically remote areas and in situations of socioeconomic vulnerability. Among the worst medical demography indexes in the country stand out the ones from the Northern region. With a wide geographical territory, low population density and local population in riverside areas, the North has the lowest ratio of physicians per thousand inhabitants in Brazil. In order to solve these problems, programs such as Programa Mais Médicos - More Doctors Program (PMM) and the Programa de Melhoria do Acesso e da Qualidade da Atenção Básica - Program of Access and Quality Improvement in Primary Care (PMAQ-AB) were developed. However, only the quantitative increase of professionals and care units are not synonymous of quality and guarantee of access to health. That way, the present study aimed to evaluate the performance of the 1.831 Family Health Teams, with and without a professional from the PMM, in improving access and quality of primary care (PMAQ-AB) in the Northern region of Brazil, since data from the third cycle of the Program. For this purpose, 15 indicators available within the different phases of the 3rd cycle of the PMAQ-B were evaluated. The analysis of the indicators showed that, sometimes, only the presence of a family health team does not ensure the care of the population covered, even when the presence of PMM professionals is verified. However, there was a better performance by the PMM teams in terms of reception and health promotion. In the same way as greater differences in performance were noticed among professionals with CRM Brazil, Individual Exchange Students and Cooperative Members. In addition, the low levels of certifications point to possible failures in the PMAQ management, especially in relation to the integration of professionals in the actions of the Program that guarantee a good evaluation of the teams