期刊名称：Revista Brasileira de Medicina de Família e Comunidade
印刷版ISSN：1809-5909
电子版ISSN：2179-7994
出版年度：2013
卷号：8
期号：29
页码：235-243
语种：Portuguese
出版社：Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
摘要：Objective: To investigate the association between primary health care (PHC) quality and diabetes mellitus (DM) management in adult patients living within the catchment area of PHC services in Porto Alegre, Brazil. Methods: Cross-sectional, population-based study of adults reporting known diabetes. Quality of PHC was assessed through the Primary Care Assesment Tool (PCATool-Brazil). Statistical analyses were performed with Poisson regression with robust variance. Results: Of the 3,014 adults interviewed, 205 (6.8%) reported having diabetes; of these, 64.4% were women and 68.3% were white. Regarding PHC score of the health service attended, people with diabetes that were classified with a high PHC score, presented longer duration of disease (10.9 vs 8.4 anos, p=0.03) and greater frequency of diabetes-related complications (75.3% vs 58.8%, p=0.02). Regarding the proportion of respondents with good glycemic control, no significant difference between groups was found (31.7% vs 38%, p=0.3). In the multivariate analysis, services with a high PHC score presented a better profile of care for the prevention of the main comorbidities – greater blood pressure assessment (PR=1.07; CI95% 1.01-1.14), lipid profile request (PR=1.23; CI95% 1.09-1.39), counseling for physical activity (PR=1.50; CI95% 1.21-1.86), foot examination (PR=2.08; CI95% 1.54-2,81), and counseling for foot care (PR=1.37; CI95% 1.18-1.59). Conclusion: High PHC score services showed better performance in the management of diabetes and care for more complicated patients, but they did not differ significantly from lower PHC score services in terms of patients’ glycemic control.
关键词：Primary Health Care;Diabetes Mellitus;Health Services Research;Atención Primaria de Salud;Diabetes Mellitus;Investigación sobre Servicios de Salud;Atenção Primária à Saúde;Diabetes Mellitus;Pesquisa sobre Serviços de Saúde
