Modelo de análise de unidades da atenção básica de saúde pública com base na metodologia multicritério linguística

Abstract

The formulation of public health policies generates short, medium and long-term impacts on society. A proper formulation process must consider the perceptions and evidence of all stakeholders. In particular, in public health, the decision-making process is characterized by complexity, conflict of interests or opposition in the analysis of priorities. Over the last 30 years, Brazilian public health has been the target of several discussions and studies. The last 18 months global scenario change. The Brazilian health system has been working at the limit of its capacity and, in specific regions, it has experienced organizational collapse. As an optimization strategy, the Brazilian structure has Basic Health Units (UBS) and Family Health Units (USF), both operating in Primary Care (AB), level of initial care and form of admission to the health system in good conditions. non-emergencies. Thus, the is study's objective is to develop an evaluation model for UBS and USF, which considers the perceptions of users, health professionals, and managers through the multicriteria decision methodology (MCDA). For the construction of the model, the evaluation criteria and the problems listed in the public health system (SUS) were identified. The Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) was selected to evaluate the research alternatives, and the perception of the interest groups was captured through the 2-TUPLE linguistic method. The criteria weights and the identification of relevant analysis alternatives were defined through consultation with specialists in the field of public health. As a form of validation, the model was applied in five units located in a city southwest of Paraná. The survey results allowed us to identify priorities from the perspective of the respondents, elucidating crucial issues for the development of public health policies in line with the concerns of the interest groups. The research instrument proved to be an adequate tool for evaluating and prioritizing improvement actions. Furthermore, it allowed the identification of fundamental aspects for the elaboration of public health policies in line with the perception and expectations of patients, health professionals and public managers. After collecting information, the data were tabulated and processed according to the proposed methodology considering 11 distinct groups. In the end, it was possible to identify that waiting for exams, interruption or discontinuity in treatment and the delay between exams and outpatient consultation were the issues identified as priorities. Although the study has achieved the proposed objective, it is suggested that the model be applied in other cities at a more usual time.