Comparação da proporção de cura por tuberculose segundo cobertura e tempo de implantação de Saúde da Família e fatores socioeconômicos e demográficos no município do Rio de Janeiro, Brasil, em 2012 / Cure rates for tuberculosis in the municipality of Rio de Janeiro, Brazil, in 2012 compared with coverage by, and time of establishment of, Family Health units, and socio-economic and demographic factors

Resumo A tuberculose (TB) consiste na maior causa de morte por doenças infecciosas em adultos. Está diretamente associada ao acesso aos serviços de saúde e a fatores socioeconômicos. A partir da reforma de atenção primária no Município do Rio de Janeiro (MRJ), a cobertura de saúde da família (SF) passou de 7% em 2010 para 48,2% em 2014. O objetivo deste artigo é comparar a proporção de cura por TB segundo a cobertura e tempo de implantação de SF e fatores socioeconômicos e demográficos no MRJ a partir dos casos novos em 2012. Foi encontrada associação entre cura por TB e a variável sexo OR 1,40 (IC95% 1,21-1,62) e entre pessoas residentes em favelas OR 0,86 (IC95% 0,73-1,02), porém não houve associação com a cobertura de SF e com o tempo de implantação das equipes. A cobertura de SF no MRJ se deu prioritariamente em áreas de maior vulnerabilidade. Aproximadamente 91% das equipes foram implantadas há menos de 05 anos da data do diagnóstico. Esses fatores provavelmente contribuíram para que não tenha sido possível detectar melhores resultados na cura de TB em áreas cobertas por SF no ano de 2012.

Abstract Tuberculosis (TB) has high prevalence and is considered a world emergency by the World Health Organization (WHO), being the greatest cause of death from infectious diseases in adults. It is directly associated with access to health services and socio-economic factors. A reform of Primary Care in the municipality of Rio de Janeiro began in 2010, with coverage increasing from 7% in that year to 48.2% in 2014. This article compares the proportion of cures of TB, coverage by the Family Health Strategy (FHS), how long it has been in place, and socio-economic and demographic factors in the municipality of Rio, based on new cases notified in the year 2012. An association was found between cure of TB and the variable gender, being 40% greater in females – odds ratio 1.4 (CI95% 1.21–1.62); and with residence in favelas – OR 0.86 (CI95% 0.73–1.02), but there was no association with coverage of the FHS (OR 1.06; CI95% 0.92–1.22), nor with the time for which the teams had been in place. FHS coverage in the municipality of Rio was put in place as priority in areas of greater vulnerability; at the time of this study, more than 91% of the teams had been in place for less than five years before the date of diagnosis. These factors probably contributed to it not being possible to detect better results in the cure of tuberculosis in areas covered by the FHS in the year 2012.

Evaluación de la satisfacción usuaria en un centro de atención primaria de salud / Evaluation of user satisfaction in a centre for primary health care

Los cambios en el modelo actual de la atención de Salud y la incorporación del modelo de salud familiar, han producido un cambio en la importancia de la familia, de la comunidad y del individuo tanto en la promoción, como la protección de salud. Este cambio ha provocado una necesidad creciente de entregar atención de calidad, donde la opinión y percepción del usuario se hace fundamental. El objetivo de este estudio fue evaluarla percepción de los usuarios del CESFAM Puertas Negras hacia la atención de Salud, como también, el grado de satisfacción usuaria frente a la atención de los distintos funcionarios. Se aplicó un cuestionario llamado “Encuesta de satisfacción usuaria – tu opinión vale” a 252 usuarios del CESFAM. Resultados y discusión: Se observó que el grado de satisfacción global de los usuarios no es óptimo y que el punto crítico más importante se visualiza en el área del acceso a la atención. Esta encuesta fue un primer paso para evaluar la satisfacción usuaria a nivel local, para realizar intervenciones que se adecuen a la necesidad de los pacientes. Creemos que se necesita de mayores estudios para evaluar la satisfacción usuaria de forma objetiva e integral.

The changes in the current health care system, and the introduction of a family health model have produced a transformation in the importance of family, community and the individual, both in health promotion as in health protection. This change has resulted in the need to deliver quality care, where user’s opinion and perception is essential. The aim of this study is to evaluate users’ perception of “CESFAM Puertas Negras” as a health care institution, as well as their satisfaction in relation to its health providers. A survey named “Survey of user satisfaction -your opinion counts” was applied to 252 users of the CESFAM. Results and discussion: The results show that the level of overall user satisfaction is not optimal, and that the worst performance is observed in the access to care module. This survey constitutes the first step towards assessing locally user satisfaction, with the aim of putting forward interventions that really suit the patients’ needs. We believe that further studies are needed to assess user satisfaction in a more objective and comprehensive manner.