Analysis of the performance of ambulatory surgery in primary health care by the family physician from the perspective of qualification and resolution of care in the city of Rio de Janeiro

Abstract

Introduction: The Family Health Program was created in 1994 and was reoriented as a strategy to change the care model from 1998 onwards, becoming a model for the organization and qualification of Primary Health Care in Brazil. In Rio de Janeiro city, in recent years, there has been a rapid increase in the coverage of the population by the family health teams, with the perspective of developing comprehensive Primary Health Care. In this perspective emerges the outpatient surgery, which has been incorporated very timidly to the practices of the Basic Health Units. Objectives: This article analyzes the incorporation of outpatient surgery by the Family Health Teams as one of the aspects involved in the expansion of the coordination of care and the resolution of Primary Health Care in this municipality. Methods: A descriptive exploratory study was carried out using the data analysis of the production of surgical procedures in the basic care network of the city. The study analyzed the information available on the Carteirômetro database for the period of October 2015 to March 2017, in addition to online interviews with family doctors working in the Family Health Strategy. It was observed that the expansion of the Family Health Strategy teams during the study period was accompanied by the percentage increase in outpatient surgery procedures (63.8%). Results: However, this evolution also represents a timid amount of surgeries performed by the number of teams implanted, that is, about 1.5 procedure/team in the last quarter surveyed. Conclusion: Among the limiting factors for the development of these interventions in Primary Health Care was the lack of professional training for the execution of these procedures, as well as inadequate physical and procedural structure of the health units.