Caracterização da demanda espontânea com queixa clínica na atenção primária à saúde de Belo Horizonte e sua associação com o índice de vulnerabilidade da saúde

Abstract

The Primary Health Care in Belo Horizonte is made by complex health units to constitute the preferential entry door for health system users. A major challenge is equalizing several activities and population needs among elective care and spontaneous demand. Allowing morefairness, completeness and expanded access. This study has as objective to analyze the spontaneous demands profile with clinic issues registered during users risk classification, at Primary Health Care in Belo Horizonte between 2014 and 2015 and associate this to the socioeconomic context from the Index of Health Vulnerability. The knowledge of that characteristics is important for a greater planning of health actions in the city, health units or even for the Family Health Team. A descriptive analysis was made of major issues and from the characteristics of care, through a distribution of simple frequency and crossed with Index of Health Vulnerability, in addition to the multivariate analysis for qualitative variables. Visits made at 44 health units were 11,6% spontaneous demand with clinic issues, from this 86,6 %had low severity and only 13,4% urgency and emergencies. The female uses more services, been 64,8% of all attendants and males 35,2%. About utilization services, just 23,4% of the whole population accessed those units but has significant difference among Index of HealthVulnerability strata. On very high risk, the utilization index is ten times higher than low risk and has a progressive association between the number of visits done by a person and the social vulnerability. Those data show improvements in health services access of a high vulnerable population. This gives larger equity on health public assistance. That group has worse social economic conditions and bigger susceptibility to sickness and death. Was found that major attendants (visits) realized by a person have distinct issues. But how higher that number is, bigger those attendants by the same issue is. The most frequent issues were:headache, worried parents and throat pain. The health teams must start its works with the most prevalent issues in its area, having large sight over individuals and collective needs, planning actions that could influence determinants. The spontaneous demand attendants, with or notclinic issues, also need to achieve a wide Primary Health Care model to offer an integral care, longitudinal and with more solubility. Therefore, is important on each meeting, between user and worker, actions be realized centralized on the person and all his integrity.