Evaluation of micro-level management of older person care in primary health centers in a health region in the Federal District of Brazil

• Published in: Ciência & saude coletiva 2019-06, Vol.24 (6), p.2173
• Main Authors: Costa Silva Sacco, Ruth da Conceicao, Ramos Cardoso, Paulo Ricardo dos, Fonseca Escalda, Patricia Maria, Guimaraes Assis, Marcella, Ferreira Guimaraes, Silvia Maria
• Format: Article
• Language: Spanish
• Subjects: Absenteeism; Demographics; Elder care; Epidemiology; Health care delivery; Health centres; Health services; Management; Primary care
• ISSN: 1413-8123; 1678-4561
• DOI: 10.1590/1413-81232018246.08332019

Primary health centers (PHCs) should consider the demographic and epidemiological profile of the health region to respond to population aging and structure service delivery around networks based on macro and micro-level management to ensure the provision of comprehensive services. A normative evaluation of micro-level management in four PHCs in a health region in the Federal District of Brazil was conducted to inform the development of recommendations for enhancing the delivery of comprehensive and integrated long-term care for older persons. A management evaluation matrix was used where management stages were classified as advanced, intermediate and incipient. The findings show that none of the PHCs were at the advanced stage, three were at the intermediate stage, and one at the incipient stage. The lowest scores were obtained for the subdimensions care model (which was shown to be predominantly traditional) and humanization (fragmentation of care). Lack of infrastructure and staff absenteeism were shown to be constraining factors, while effective communication with local administrators was as facilitating factor. Improvements need to be made in micro-level management to enhance the delivery of comprehensive and timely care to older persons in this health region.