Coordination in Primary Care and integration in the Health Care Network: How far have we progressed?

Abstract

This study aimed to analyze the capacity for coordination in Primary Care in Brazil (2012 and 2018) and the integration with other levels of care. Cross-sectional and longitudinal descriptive study, using data from the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB). 15,378 teams from the 1st and 3rd PMAQ-AB cycles were selected, 59,354 users from the 1st cycle and 56,369 users from the 3rd cycle. Improvements were found in the prevalence of teams that have the support of other professionals in the network, and most of them have regulation centers; in the percentage of teams that ensure that users are scheduled with specialists; and most services provide scheduling for priority population groups; there was an increase of teams that have defined references and direction for the service in the network; increase in the number of teams that schedule appointments and tests and organize referrals based on risk and vulnerability assessment; and increase in the prevalence of teams that use electronic medical records. There was an improvement in the ability to exercise the coordinating role in health care networks, particularly in improving the ordering of care flows, and providing better care management.