Análise do Programa de Melhoria do Acesso e da Qualidade na Atenção Básica (PMAQ-AB) de acordo com o Modelo teórico de Atenção às Condições Crônicas

Abstract

This study aims to estimate the ability of the Brazil’s External Evaluation Instrument of the Access and Quality Improvement Program in Primary Care (PMAQ-AB) applied in 2013 and 2014, for assessment of care for chronic conditions. Chronic diseases are responsible for the greatest impact on the burden of disease of the world's population and the main challenge of today for health systems in all countries. The care for chronic conditions in health systems and health services requires the adoption of a new theoretical model, to reorganize the way it is currently done health care and direct focus to chronic conditions, with greater efficiency and resolution. The Chronic Care Model (CCM) is the theoretical framework from which was made this study. It was proposed in 1998 and since then has influenced the organization of national health plans of several countries, with evidence of its effectiveness. The methodology used was the comparative reading of the External Assessment Tool of the PMAQ-AB regarding the evaluation tool of chronic care capacity proposed by CCM, called Assessment of Chronic illness Care (ACIC), with the objective of identifying the correspondences between the two. The results allow us to observe that the Brazilian instrument does not have all the necessary requisites to evaluate the quality of care for chronic conditions in Primary health Care, according to ACIC, with the main correspondences identified in relation to the organization of work processes of the team and attention to the life cycles and health conditions. Several elements of chronic care in PMAQ-AB have also been identified, which can be redirected and qualified in order to build an assessment tool that improves the orientation of teams of health care for chronic conditions. Therefore, some proposals for additions to this one were elaborated, in order to qualify the evaluation of the approach of chronic conditions.