Revista de Saúde Pública
Print version ISSN 0034-8910
SALA, Arnaldo et al. Evaluation of management of patients with chronic degenerative diseases in a primary health clinic. Rev. Saúde Pública [online]. 1993, vol.27, n.6, pp. 463-471. ISSN 0034-8910. http://dx.doi.org/10.1590/S0034-89101993000600009.
The efficacy of health actions, related to arterial hypertension and used as a strategy to decrease morbi-mortality due to cardiovascular diseases, in accordance with the "risk approach" and carried out in a Primary Health Care Clinic is assessed. These actions are based on the detection of arterial hypertension in the adult population attended at the Clinic and on the control of blood pressure levels in hypertensive individuals in which other known risk factors continue to be controlled, as well as on further treatment of eventual complications. Data relating to the 3,793 patients who were attended at least once by doctors of the adult sector of a training health-center located in S. Paulo county (Brazil) during the period from June 1990 to May 1991, inclusive, were evaluated. This evaluation was made according to each diagnosis undertaken as well as to the concentration of each type of consultation whether occasional, or follow-up. Of these 3,793 patients analysed, 839 presented arterial hypertension and/or diabetes, and were grouped into four categories: the exclusively hypertensive, the hipertensive with other associated chronic diseases (except diabetes), the diabetic and the diabetic with arterial hypertension. The results of this study brougth the following aspects to light: 1) The low coverage of hypertensive individuals and diabetics being attended by the health service when only the population attended by the health service is taken into consideration. 2) The incidence of patients diagnosed as hypertensive in occasional consultations who did not return to the health service for medical follow-up indicates the difficulties involved in attracting such individuals permanently. This loss is due to both the non-appearance of patients at the consultations programmed for their follow-up as well the lack of the follow-up program on the part of the health service. 3) With regard to these that fulfilled the follow-up program, the concentration of medical consultations and the concentration of absences presented satisfactory proportions, compatible with the proposal of quartely medical consultations. 4) The category of exclusively hypertensive individuals presented a lower concentration of attendance at consultations and a higher proportion of absences per consultation planned than did the others categories. Finally, the limitations of the actions based on the risk approach for the control of Chronic Degenerative Diseases are discussed.
Keywords : Outcome and process assessment (health care); Hypertension [prevention]; Program evaluation; Primary health care.