Evaluation of the implementation of advanced access on the quality indicators of a health unit
DOI:
https://doi.org/10.5712/rbmfc15(42)2360Keywords:
Advanced Access, Indicators and Reagents, Health Centers.Abstract
Objectives: The main objective was to analyze the access indicators of the Sesc health unit (HU), before and after the implementation of advanced access (AA). As a secondary objective, the performance indicators of the health unit Sesc HU were analyzed, before and after AA. Methods: Cross-sectional descriptive study with analysis of data obtained monthly from the health information system of Grupo Hospitalar Conceição, comparing the period of November/16 - October/17 with November/17 - October/18. Results: After AA, the number of medical appointments increased by 8%, absenteeism in consultations decreased from 6.9% to 3% and the number of different patients treated increased by almost 5%. Regarding the control of chronic diseases, the number of hypertensive patients seen increased and there was also an increase in the percentage of controlled hypertensive patients, from 74% to 77%. The number of diabetics treated increased, as did the percentage of controlled diabetics increased from 73% to 81%. There was a decrease of almost 10% in attendance to patients linked to the US in the reference secondary care services. Discussion: It is possible to consider that the implantation of AA in Sesc HU was associated with an improvement in access indicators, as well as most of the performance indicators analyzed.
Downloads
Metrics
References
(1) Starfield B. Acessibilidade e primeiro contato: “a porta”. In: Starfield B, org. Atenção primária: equilíbrio entre necessidades de saúde, serviços e tecnologia. Brasília (DF): UNESCO/Ministério da Saúde; 2002. p. 207-45.
(2) Lippman H. Same-day scheduling. Hippocrates. 2000;2:49-53.
(3) Murray M, Berwick DM. Advanced access: reducing waiting and delays in primary care. JAMA. 2003;289:1035-40. PMID: 12597760 DOI: https://doi.org/10.1001/jama.289.8.1035 DOI: https://doi.org/10.1001/jama.289.8.1035
(4) Mendes EV. O acesso à atenção primária em saúde. Brasília (DF): Conselho Nacional de Secretários de Saúde (CONASS); 2017.
(5) Murray M, Tantau C. Same-day appointments: exploding the access paradigm. Fam Pract Manag. 2000 Set;7(8):45-50.
(6) Knight AW, Padgett J, George B, Datoo MR. Reduced waiting times for the GP: two examples of advanced access in Australia. Med J Aust. 2005 Jul;183(2):101-3. PMID: 16022626 DOI: https://doi.org/10.5694/j.1326-5377.2005.tb06941.x DOI: https://doi.org/10.5694/j.1326-5377.2005.tb06941.x
(7) Witt MJ. Advanced access works! Improved patient satisfaction, access, and P4P scores. El Segundo, CA: Greenbranch Publishing; 2006.
(8) Mallard SD, Leakeas T, Duncan WJ, Fleenor ME, Sinsky RJ. Same-day scheduling in a public health clinic: a pilot study. J Public Health Manag Pract. 2004 Mar/Apr;10(2):148-55. DOI: https://doi.org/10.1097/00124784-200403000-00009 DOI: https://doi.org/10.1097/00124784-200403000-00009
(9) Kennedy JG, Hsu JT. Implementation of an open access scheduling system in a residency training program. Fam Med. 2003 Out;35(9):666-70.
(10) Leal AEB, Watanabe BT, Bezerra CW, Palluello RAS, Gyuricza JV, Rewa T, et al. Acesso avançado: um caminho para a integridade na atenção básica. São Paulo (SP): Secretaria Municipal de Saúde/Coordenadoria Regional de Saúde Oeste; 2015.
(11) Arrojo Junior JC, Fabi LF. Impacto do acesso avançado na capacidade de agendamento futuro em unidade básica de saúde do município de São Paulo. Med (Ribeirão Preto). 2014;47(Suppl 5):19.
(12) Belardi FG, Weir S, Craig FW. A controlled trial of an advanced access appointment system in a residency family medicine center. Fam Med. 2004 Mai;36(5):341-5.
(13) Asfor ATP, Shinkai MP, Monteiro ABC, Freitas HC, Shinkai H. Implantação do acesso avançado como medida resolutiva ao absenteísmo às consultas programadas. In: Anais do Congresso Sul-Brasileiro de Medicina de Família e Comunidade. 12th WONCA World Rural Health Conference; 3-5 abr 2014; Gramado, Rio Grande do Sul, Brasil. Gramado (RS): WONCA/SBMFC; 2014.
(14) Vidal TB. O acesso avançado e sua relação com o número de atendimentos médicos em atenção primária à saúde [dissertação]. Porto Alegre (RS): Universidade Federal do Rio Grande do Sul (UFRGS) - Programa de Pós-Graduação em Epidemiologia; 2013.
(15) Sperl-Hillen JM, Solberg LI, Hroscikoski MC, Crain AL, Engebretson KI, O’Connor PJ. The effect of advanced access implementation on quality of diabetes care. Prev Chronic Dis. 2008 Jan;5(1):A16.
(16) Radel SJ, Norman AM, Notaro AM, Horrigan DR. Redesigning clinical office practices to improve performance levels in an individual practice association model HMO. J Healthc Qual. 2001 Mar/Apr;23(2):11-5. DOI: https://doi.org/10.1111/j.1945-1474.2001.tb00330.x DOI: https://doi.org/10.1111/j.1945-1474.2001.tb00330.x
(17) Solberg LI, Maciosek MV, Sperl-Hillen JM, Carin AL, Engebretson KI, Asplin BR, et al. Does improved access to care affect utilization and costs for patients with chronic conditions?. Am J Manag Care. 2004 Out;10(10):717-22.
(18) Rose D, Ross JS, Horwitz LI. Advanced access scheduling outcomes: a systematic review. Arch Intern Med. 2011 Jul;171(13):1150-9. DOI: https://doi.org/10.1001/archinternmed.2011.168 DOI: https://doi.org/10.1001/archinternmed.2011.168
(19) Pires Filho LAS, Azevedo-Marques JM, Duarte NSM, Moscovici L. Acesso avançado em uma Unidade de Saúde da Família do interior do estado de São Paulo: um relato de experiência. Saúde Debate. 2019 Abr;43(121):605-13. DOI: https://doi.org/10.1590/0103-1104201912124 DOI: https://doi.org/10.1590/0103-1104201912124
Downloads
Published
How to Cite
Issue
Section
License
By submitting a manuscript to the RBMFC, authors retain ownership of the copyright in the article, and authorize RBMFC to publish that manuscript under the Creative Commons Attribution 4.0 license and identify itself as the vehicle of its original publication.