Modelos de núcleos de apoio à saúde da família desenvolvidos nas microrrealidades nacionais: uma análise a partir do 2º ciclo de avaliação externa do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica

Abstract

Matrix support, in primary health care, is characterized as a means of reorganize work processes and promote the expansion of clinical services, the resolution capability in this field, and the crtitical thinking about established practices. From this perspective, the Family Health Support Centers - NASF were created to work in partnership with the primary care teams - EqAB, establishing specialized rearguard and aiming to provide the integrality of care. Considering this situation, it was intended, among other things, to identify the patterns of support offered by the NASF that has developed in the national scenario, according to the prerogatives of the Brazilian Ministry of Health. For this purpose, data from module II were used in the second external evaluation cycle of the National Program for Access and Quality Improvement in Primary Care - PMAQ-AB. This study had a sample of 14,927 EqAB, of which the information provided subsidized the construction of a decision support system DSS. Techniques of cluster analysis and correspondence analysis were used as statistical tools for the elaboration, processing and validation of the decision model (of DSS). Based on NASF's classificatory scores for clinical-assistantial and technical-pedagogical actions, assigned by the referral teams, there were eleven (11) distinct patterns of performance among the centres. The centres that have worked intensely in clinical-assistantial and technicalpedagogical actions, are mainly from modality 1 of NASF. This modality massively performs, among the attributions punctuated in PMAQ-AB, home visits; individual consultations; therapeutic groups; health education actions; actions of intervention in the community and others. The proposed DSS proved to be valid and adequate to this reality. It was sensitive to the identification of the permeated patterns and, evidenced the need for focused research on the work processes of the NASF. The statistical techniques used together proved to be adequate to the reality of health phenomena, especially, when the use of databases with a great amount of elements was necessary.