Rede de cuidados à pessoa com deficiência em Minas Gerais: análise da qualidade do cuidado sob a perspectiva de usuários e acompanhantes

Abstract

Introduction: promoting the development of human potentialities and functionality is a fundamental action to provide adequate care and guarantee access to the rights of persons with disabilities. Thus, it is extremely important to evaluate the Quality of Care in the health area, from the perspective of the population served, so that the relationships between users and health services are better understood. Purpose: to investigate the Quality of Care self-referred by the users of the Care Network to the Person with Disabilities in Minas Gerais. Methods: observational, descriptive and cross-sectional study. The study included 871 users of 36 services of the specialized component of the Care Network to the Person with Disabilities distributed in the 13 expanded health regions. Three instruments were used: a User Interview Roadmap and Brazil's Economic Classification Criteria for socio-demographic, clinical and care characterization, as well as the Quality of Care Scale. A descriptive analysis of the frequency distribution of the categorical variables and analysis of the measures of central tendency and dispersion of the continuous variables were carried out. For the psychometric analysis of the instrument Quality of Care Scale were used the Item Response Theory and Factor Analysis, as well as measures of convergent validity and reliability. The Kruskal-Wallis, Nemenyi and Mann-Whitney tests were used to verify the statistical differences between the medians of the explanatory variables (gender, age, schooling, household income and type of disability) and response of significance of 5%. Results: the majority of the participants were male, single, who did not work and had income of a minimum wage. The largest proportion had incomplete Elementary School, was brown or black, with a household income greater than one and up to two minimum wages. The average age of the users was 28.6 years, of which 50.0% were up to 14 years. Most declared intellectual disability. In the psychometric analysis, all items were relevant and with acceptable discrimination for the formation of the constructs, except for a Received Information item, which was removed from the final model because it presented a very low factorial load. Statistical differences regarding the Quality of Care were identified in relation to the General Score, age group and type of disability; Professionals and Attendance, age group and schooling; Access, age range and type of disability; Social needs, age range, schooling and type of disability; Information Received, schooling and household income. Conclusion: It was possible to know the profile of the users of the Care Network for the Person with Disabilities of Minas Gerais, as well as the Quality of Care panorama referred to by them in relation to the quality of the team, access, social needs and information received. The psychometric analysis of the Quality of Care Scale instrument revealed that the final model presented in this study can be expanded to measure the Quality of Care offered to people with all types of disabilities. The Access axis presented the lowest Quality of Care scores and, despite positive evaluations, it was then possible to identify which aspects could be improved. Improving the waiting time to receive care and the offer of services in the place where the user resides, to facilitate access to consultations and medicines, to contribute intersectorally in leisure and social activities are actions that can contribute to increase the Quality of Care.