THE COORDINATION OF CARE IN PMAQ-AB- AN ANALYSIS BASED ON THE ITEM RESPONSE THEORY
Author(s)
Souza MF, Santos Ad, Matta Machado AT, Reis IA, Santos MA, Andrade EI, Cherchiglia ML
Federal University of Minas Gerais, Belo Horizonte, Brazil
OBJECTIVES: Health systems have invested in Primary Health Care as an organizational strategy for appropriate responses to the health needs of the population. The study aimed to assess the quality of National Program for Access and Quality Improvement of Basic Attention’s variables (PMAQ-AB) to evaluate primary care as coordinator of care in Brazil. METHODS: This was a cross-sectional study based in Item Response Theory (IRT), with data collected of PMAQ-AB in 2012. The study included 17202 primary care teams. The Samejima’s Gradual Response Model was used to estimate the parameters of the items and the score related to the level of coordination. The Cronbach's alpha and the Spearman’s coefficient were used to analyze the internal consistency and the correlation between the items and the total score. The assumptions of unidimensionality and independence of the items were assessed. Based on scores achieved by the teams, the usual IRT scale was categorized in four levels of coordination. The word cloud’s graph helped in interpreting the built levels. RESULTS: The items with greater discrimination of the coordination level were the existence of telephone/internet, institutional communication flows and matrix support actions. The frequency of experts’ contact with primary care professionals and integrated electronic medical records demanded higher level of coordination of teams. The total Cronbach’s alpha of the items was 0.8018. Institutional communication flows had higher correlation with the total score. The assumption of unidimensionality was considered valid. The coordination scores ranged from -2.673 (minimum) and 2.835 (maximum). A greater degree of communication, information exchange, matrix support, care in the home and territory had a relevant weight in coordination levels. CONCLUSIONS: The ability to make the information available and the frequency of contact between professionals are important elements for comprehensive care, continuous and quality.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PHP84
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes, Health Disparities & Equity, Hospital and Clinical Practices, Quality of Care Measurement
Disease
Multiple Diseases