Questionnaire of Shared Diagnosis in Primary Care: typical x expanded Family Health teams

Abstract

Increase in clientele, relationship between the primary care team and the specialties, health promotion activities, and infrastructure conditions are organizational factors the Family Health Strategy needs to contribute to provide comprehensive care in the Brazilian National Health System. This article aims to compare the results of applying the Questionnaire of Shared Diagnosis in Primary Care (QD-CAB), concerning the issues related to comprehensiveness, between typical and expanded Family Health teams in a town in the state of São Paulo, Brazil. The method and QDCAB were applied to typical Family Health teams and those having specialists in the major areas (expanded teams), and the analysis was conducted using the Wilcoxon-Mann-Whitney test, enabling comparison of the distribution of answers between the two team models. Expanded teams establish a rather collective bond (0.0026), however, there was no difference in the results of efforts in this regard between the two team models (0.7227). The low marks assigned to issues concerning the relation of the team to the specialists, overall, reveal the difficulties in ensuring comprehensive care. Health promotion activities were assigned high marks from both models. The adequacy of physical structure in the health center was assigned lower marks from the typical teams (< 0.0001). The relation of the teams to the specialists is an obstacle to ensuring comprehensiveness and, regarding typical teams, excessive demand and the infrastructure conditions also pose difficulties.