title: The effects of a people-centred model on longitudinality of care and utilization pattern of healthcare services--Brazilian evidence.
abstract: Brazil is experiencing a time of change in pattern of care: from 'traditional' to Family Health Strategy (FHS), a model guided by the principles of people, family and community-centred medicine. The heterogeneity in care currently offered affects the primary care impact. This study aims to evaluate the longitudinality of care and correlate this primary care principle to the utilization pattern of care among patients hospitalized due to preventable conditions, comparing the two care models currently offered in Brazil. It is a cross-sectional, analytical and descriptive study with a quantitative approach. The sample consisted of 501 patients from 0 to 14 years old. Data was collected in 2011 and the Primary Care Assessment Tool (PCATool-Brazil) child version was used. Bivariate and multivariate analyses were performed including patient-related variables (age, maternal education, income and type of diagnosis) and care model. From the hospitalizations occurred during the period, 65.2% were Ambulatory Care Sensitive Conditions. Patients evaluated 'longitudinality' as regular. Both the care continuity dimension and the utilization pattern of care services showed a link with the care model offered. Findings suggest that the FHS care model, based on the assumptions of people-centred medicine, was associated with better ratings of care continuity, which was reflected in a more appropriate utilization pattern of care services.
authors.affiliation: Department of Pediatrics, School of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647., 05403-000 São Paulo, SP, Brazil ana.ferrer@hc.fm.usp.br.
authors.forename: Ana Paula Scoleze
authors.initials: AP
authors.lastname: Ferrer
authors.affiliation: Department of Pediatrics, School of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647., 05403-000 São Paulo, SP, Brazil.
authors.forename: Alexandra Valéria Maria
authors.initials: AV
authors.lastname: Brentani
authors.affiliation: Department of Pediatrics, School of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647., 05403-000 São Paulo, SP, Brazil.
authors.forename: Ana Cecília Silveira Lins
authors.initials: AC
authors.lastname: Sucupira
authors.affiliation: Department of Pediatrics, School of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647., 05403-000 São Paulo, SP, Brazil.
authors.forename: Ana Carolina Barsaglini
authors.initials: AC
authors.lastname: Navega
authors.affiliation: Department of Pediatrics, School of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647., 05403-000 São Paulo, SP, Brazil.
authors.forename: Elisa Scanavini
authors.initials: ES
authors.lastname: Cerqueira
authors.affiliation: Department of Pediatrics, School of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 647., 05403-000 São Paulo, SP, Brazil.
authors.forename: Sandra Josefina Ferraz Ellero
authors.initials: SJ
authors.lastname: Grisi
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018802:Patient-Centered Care; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: Avoidable hospitalization; family medicine; healthcare evaluation; longitudinality; people-centred care; primary care; utilization of health services