Avaliação comparativa da integralidade dos serviços de saúde: o Mais Médicos e a Residência na percepção de médicos que participaram dos dois programas no Rio Grande do Norte

Abstract

Primary Health Care (PHC) in Brazil has been undergoing numerous transformations since its implementation, always seeking improvements in the care of its users. The creation of new policies and public projects aimed at expanding Family and Community Medicine (FCM) and qualification has been quite visible in recent years, experienced in different regions and communities, which demonstrates a certain diversity in the levels of quality of PHC, in especially when it comes to comparing programs. Thus, this research aims to: understand how the attribute of comprehensiveness in health services is worked on in the More Doctors Program (PMM) and in the Medical Residency Program in Family and Community Medicine (PRMFC), under the perception of doctors participating in these programs. This is a descriptive-comparative field study, with a qualitative approach, however, with quantitative descriptions to complement the findings; carried out through participant observation, interview and application of the questionnaire called the Primary Care Assessment Instrument (PCATool-Brasil), both aimed at physicians who worked at the Residence and Mais Médicos, in the municipality of Mossoró in the interior of the state of Rio Grande From north. As a result, two programs with great importance in the qualification of PHC were obtained. The PRMFC is focused on training specialists to work in PHC and greater stimulation of personal and community development, which consequently draws more attention for accumulating more than one training process. Meanwhile, the PMM, focused on filling medical gaps in places where FCM is difficult to provide, brought qualification to PHC with little stimulus to the academic profession and, since its educational axis does not have the same quality as a medical residency. Mais Médicos is often used as a transition to different medical specialties. After an evaluation using the PCATool, it was possible to conjecture that residencies, within the scope of the researched context, continue to be the gold standard of training processes in medicine and are preferred by newly graduated physicians. Meanwhile, the PMM is less sought after by this public, although in terms of the PCATool evaluation, scores with significant differences between the two programs have been shown. However, it was possible to identify gaps in the processing of the integrality attribute made available by the program, however, it is still subject to evaluation and studies focusing on the challenges that the PMM has to develop strategies to move forward.