Aspectos estruturais de Unidades Básicas de Saúde para qualidade da atenção às pessoas com diabetes mellitus.

Abstract

The structure is one of the components for analyzing the performance of services that favor the provision of timely and quality services. In this sense, this study aims to: Analyze the structural conditions of health units and the guidelines, objectives / goals of municipal management related to the quality of these services in the capitals according to Brazilian regions, with a view to attention to people with Diabetes Mellitus. For that reason a logical model for care for people with Diabetes was elaborated, based on a normative review and on quality referential, which considered the dimensions of Management and Care, as a starting point for defining the sub-dimensions of the structure of the healthcare units. health. Such subdimensions and respective variables were used to direct the search for data related to them in the Program of the Improvement of Access and Quality of Primary Health Care, of the 3rd cycle, made available online by the Ministry of Health. The results from the bank were organized and systematized using the Stata 10 program and presented in the form of tables in numerical values and simple frequency, considering the available data of the capitals by region of Brazil. From the results on the structure of health units in Brazilian capitals, the Health Plans of those municipalities that presented a percentage of inadequacy greater than 50% for at least four dimensions among the seven analyzed in this study were selected for documentary analysis study. All results were analyzed in the light of the theoretical framework on service quality, with an emphasis on structure, and on the health plan as a management tool that directs actions to improve the quality of the health system and services. The study revealed differences between the capitals regarding aspects related to the dimensions of human resources, organization and information on the offer of actions and services. About ambience and medicines, they obtained the highest percentages of adequacy in the capitals of the Southeast and South regions. The results related to accessibility and physical structure were similar for the capitals of the various Brazilian regions, it should be noted that accessibility obtained a better overall result. The need to adapt the structural conditions of basic health units to most Brazilian capitals was highlighted in some (ns) of the aspects analyzed. Based on the analysis of the municipal health plans for the 2018-2021 quadrennium, reference was made to the PMAQ in three of these and the identification of goals related to the expansion and renovation of units, and in some, the provision of equipment for the development of the units. services. The plans brought little about the ambience and one of them established an extended working time in some of the health units as a goal. The implementation of pharmaceutical assistance was also assumed as a commitment in some plans. As a result, this study revealed aspects of the structure dimensions of health units in Brazilian capitals, which highlights the particularities, strengths and weaknesses that deserve to be considered for defining the agenda and directing actions by health management, since health conditions inadequacy can have an impact on the quality of care for people with diabetes in Primary Health Care.