Evaluation of primary health care by users during the COVID-19 pandemic: A cross-sectional study

Suely Deysny de Matos Celino; Nailton José Brandão de Albuquerque Filho; Monalisa da Nóbrega Cesarino Gomes; Gabriela Maria Cavalcanti Costa; Ana Elza Oliveira de Mendonça

doi:10.1371/journal.pone.0292039

Evaluation of primary health care by users during the COVID-19 pandemic: A cross-sectional study

PLoS One. 2023 Sep 22;18(9):e0292039. doi: 10.1371/journal.pone.0292039. eCollection 2023.

Authors

Suely Deysny de Matos Celino¹, Nailton José Brandão de Albuquerque Filho², Monalisa da Nóbrega Cesarino Gomes³, Gabriela Maria Cavalcanti Costa⁴, Ana Elza Oliveira de Mendonça¹

Affiliations

¹ Graduate Program in Collective Health, UFRN, Natal, Rio Grande do Norte, Brazil.
² Department of Physical Education, State University of Paraíba, Campina Grande, Paraíba, Brazil.
³ Department of Dentistry, Centro Universitário Unifacisa, Campina Grande, Paraíba, Brazil.
⁴ Public Health Program, State University of Paraíba, Campina Grande, Paraíba, Brazil.

Abstract

Objective: To evaluate the primary health care (PHC) attributes and associated factors during the COVID-19 pandemic using the perspective of users.

Methods: This cross-sectional, quantitative study included 422 PHC users from 96 Family Health Teams in a city in Brazil. The assessment used the Primary Care Assessment Tool (PCATool) and a structured questionnaire on the sociodemographic and epidemiological characteristics of users and basic health units (BHU). The Person's chi-square test was used to analyze the association between high overall scores in PCATool and characteristics of users and BHU. Crude and adjusted prevalence ratios (PR) with a 95% confidence interval were also calculated. Poisson regression and Rao Scott's Chi-square test were used to estimate crude PR.

Results: Most users were aged 30 to 39 years (26.3%), women (75.4%), registered at the BHU for over ten years (59.5%), and had incomplete secondary education (30.6%). The mean of PHC essential attributes and overall scores were low (6.10 ± 0.81 and 5.78 ± 0.77, respectively). "First-contact care-use" received the highest score (9.22 ± 1.62), while "first-contact care-accessibility" received the lowest (2.82 ± 0.90). High overall scores were associated with an average employment time of professionals (doctors and nurses) at the BHU (PR = 1.31; 95% CI 1.17-1.48; p < 0.001) and lower educational level of users (PR = 1.71; 95% CI 1.54-1.90; p < 0.001.

Conclusion: "First-contact care-use" was the best evaluated, while "first-contact care-accessibility" was the worst. High scores were associated with a lower educational level of users and BHU with more experienced professionals.

Copyright: © 2023 Celino et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brazil / epidemiology
COVID-19* / epidemiology
Cross-Sectional Studies
Female
Humans
Pandemics
Primary Health Care

Grants and funding

This study was partly financed by the Coordenacão de Aperfeiçoamento de Pessoal de Nıvel Superior– Brasil(CAPES)– Finance Code 001. The funding consisted of a payment of publication fees. Furthermore, it did not interfere with the study's design and collection, analysis, data interpretation, and manuscript writing. There is no additional external funding received for this study.