Análise da linha de cuidado para pacientes com diabetes mellitus e hipertensão arterial: a experiência de um município de pequeno porte no Brasil

Abstract

The article evaluates the line of care of a cohort of 260 individuals with diabetes mellitus and 295 individuals with systemic arterial hypertension before, during and after the implementation of the Laboratory for Innovations in Care for Chronic Conditions (LIACC). This intervention sought to strengthen primary health care, implementing the chronic conditions care model in the municipality of Santo Antônio do Monte, Minas Gerais, Brazil, between 2013 and 2014. This is a longitudinal observational study that uses clinical and laboratory information from the medical records of patients with these two chronic conditions between 2012 and 2017. The outcomes evaluated were based on the guidelines of the State Department of Health of Minas Gerais. The results show the LIACC associated with the universalization of primary care macroprocesses, such as registration and classification of family risk. For patients with diabetes, there was an improvement in several markers in the period, such as an increase in consultations (from 90% in 2012 to 92% in 2017) and a decrease in patients with exams outside the normal range. For individuals with hypertension, even though a marked increase in consultations was observed (from 80% in 2012 to 84% in 2017), clinical improvements were less evident. It is concluded that LIACC is a promising intervention to improve the management of patients with chronic diseases in primary health care.