Avaliação dos serviços de atenção à saúde do estomizado em Minas Gerais

Abstract

Since its conception, the Healthcare Policy to Ostomized People (HPOP) is being implemented in the healthcare services in Brazil . This policy aims to provide a network of healthcare services with appropriate structure and processes to improve quality of life of ostomized people. No studies were found in the scientific literature on the assessment of such services in the state of Minas Gerais (MG). The objective of this study was to evaluate Healthcare Services for Ostomized People (HSOP) of the Brazilian Public Health Care System in Minas Gerais, as well as to classify their degree of implementation. This is a descriptive cross-sectional study in which indicators and / or criteria related to the dimensions of structure (available resources and their organization) and process (way of producing goods or services ) of HSOP in the state of Minas Gerais were analyzed in the year of 2011. Two structured questionnaires that form the basis of the Integrated Pharmaceutical Care Management System of Minas Gerais State Secretary of Health were used for data collection. The implementation level was defined by an analysis and judgment matrix with different scores for each indicator assessed according to the level of importance for being classified as: fully, satisfactory and incipient implementation and not implemented. To validate the content and appearance of the analysis and judgment matrix Delphi technique was used. For the analysis of the data and validation of the instrument factorial analysis was also used with estimation of indices such as KMO test and Bartlett test or sphericity and Cronbach's alpha was tested to assess the internal consistency. A p value of <.05 was considered significant. The results showed that 72 % of the 28 HSOP included in the study have the structure for the registration of patients and dispensing devices and that 40 % of the units were classified as type II HSOP . In relation to processes, 96% of the units relied on the assistance of nurses, but 52% of them without specialized training. It was also observed that these professionals are more involved with the actions related to the implementation of the program than to clinical care . Based on the analysis and judgment matrix, only 11% of HSOP were fully implemented, 42% showed satisfactory implementation, 36% incipient implementation and 11% were considered not implemented. Overall, structure of HSOP was better evaluated than process. Limitations for the implementation of the program included the lack of specialized professionals to conduct training of reference and counter reference services and insufficient equipment and materials. The evaluation of HPOP in Minas Gerais showed that most of the services did not reach full implementation regarding structure and processes. This study could help to subsidize interventions to correct the distortions identified.