[Testing a methodology to evaluate organization, access, and technical quality of care for childhood diarrhea].
In order to evaluate the issues of access and technical quality in actions to control diarrhea in a selected municipality in the State of Bahia, Brazil, a study of multiple cases was conducted with two levels of analysis: practices themselves and the coordination between them. Cases were defined as hospitalization (8) or death (3) due to diarrhea. All deaths were investigated, and hospitalizations were submitted to intentional selection. Aspects and approaches vis-a-vis technical quality evaluation and estimation of the degree of implementation in diarrhea control measures were derived from the theoretical model. Health care trajectories for diarrhea were reconstituted from interviews and patient chart data. The results identified: organizational barriers related to long waiting time at primary care units; geographic barriers, or the distance from users' place of residence to health services; and financial barriers due to shortage of financial resources for transportation. Quality of care was considered inadequate, and diarrhea control measures were classified as insufficient in practically all of the dimensions analyzed.
Lopes
Rosana Machado
RM
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil. rmachado@ufba.br
Vieira-da-Silva
Lígia Maria
LM
Hartz
Zulmira M de Araújo
ZM
D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000592:standards*; D003967:Diarrhea / Q000517:prevention & control / Q000628:therapy*; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D011785:Quality Assurance, Health Care / Q000379:methods; D011787:Quality of Health Care