Avaliação da qualidade da atenção às pessoas com Hipertensão Arterial Sistêmica no âmbito da Atenção Primária à Saúde no Brasil.

Abstract

Systemic Arterial Hypertension (SAH) is considered, worldwide, as a high-prevalence chronic disease, affecting around one third of the adult population, besides being one of the most significant risk factors for the development of cardiovascular diseases. In Brazil, SAH is considered a major public health problem, with low levels of control. The study has the purpose of assessing the quality of care to patients with SAH provided by the primary healthcare teams that have adhered to the third cycle of external assessment of Brazil’s National Program for Access and Quality Improvement in Primary Care. It is a normative assessment study, using the quality assessment definition proposed by Donabedian. Accordingly, a logical operational framework was prepared in relation to the care for SAH in primary healthcare, comprising the management and care dimensions, giving origin to a matrix of criteria, indicators and standards, enabling the assessment of the degree of appropriateness of the actions and classify the criteria as adequate, intermediary or inadequate. Simple and relative frequencies were calculated for each criterion, using the R Studio software. Data was stratified by regions in Brazil. Results point out to a deficiency in the scope of the standard of quality considering the structure criteria, especially those related to the physical structure of the healthcare units, as well as the administrative and support environments, with a percentage of adequacy of 19.4%, clinical environment of care compatible with the number of teams working in such spaces (12.1%); ambience characteristics (45.8%) and accessibility for people with special needs (6.7%), as well as availability of equipment for health education activities (25.7%), not to mention the extremely low percentage of availability of basic medicines (1.3%) for the treatment of the such condition, significantly compromising its control at the primary level and indicating deficiencies in the quality of the care provided. Process criteria had a better performance, however those related to working hours of the Primary Healthcare Unit (48.0%), adscription of the population (47.1%), receptivity of spontaneous demand (6.3%) and coordination of primary care (52.4%) demand interventions aimed at improvement, once important issues in the care process of primary healthcare are reflected. Despite the existence of a set of norms related to the SAH care process of the patient in primary healthcare, issues related to the physical structure of the Primary Healthcare Units, materials, inputs and equipment are still not sufficiently adequate to guarantee quality in the care of hypertensive patients. Furthermore, qualification in the work process of the teams is necessary for Primary Healthcare to fulfill its healthcare coordination role.