Atenção primária na saúde suplementar: compreendendo os atributos essenciais em uma operadora de plano de saúde da região sudeste do Brasil

Abstract

Primary health care can be understood as the first level of care in a health system. The concept of primary care has evolved over time and the development of care practices has acquired specific characteristics in the operating health systems. Nowadays studies say primary health care should guide the care model in health systems and should be based on the essential attributes of Starfield: access, longitudinality, coordination, integrality. Recent studies suggest a strong and resolute primary care is capable of solving about 75% of the population's health problems. In Brazil, Primary Health Care was initially implemented in the Unified Health System, starting in 1994. It is observed that, over the years, important developments have been experienced in the model adopted in the Unified Health System. In the private sector, the concern with this theme is recent. In a health plan operator located in a city in the southeastern region, some practices related to primary health care have been developed over the past few years, however the adoption of PHC explicitly occurred only in 2013. The objective of this work is to understand the experiences of primary care in a health plan operator according to the essential attributes, from the perspective of customers, members and employees. This is a qualitative study, with an exploratory approach: a case study. The method of data collection was the interview using a semi-structured script. Participants were customers, employees and members of the operator under study. The content analysis technique proposed by Bardin (2016) was used for data treatment. Each attribute was considered a category of analysis and, in addition, specific model points and general aspects were considered to contribute to the discussions. The results show that the attributes of PHC are present in the health plan operator under study and are perceived differently by the interviewed groups. The responses were divided into positive, negative, neutral and absent aspects. The category that clients are most able to perceive and bring in their speeches is access and the one that appears least is longitudinality. In some categories, it is possible to notice an important number of missing answers, which demonstrates the low perception of attributes by the interviewees. In general, the attributes need to be developed so that PHC starts to deliver the expected results in the context of supplementary health. The Technical Report on Actions to Strengthen Primary Health Care was proposed, as a technical product of the Master in Health Services Management, to contribute to the implementation and improvement of primary care in the health system, especially in health plan operators.