Organization and performance of primary care during the pandemic: a cross-sectional study based on municipal population size¹

Abstract

Objective: to analyze the organization and care provided by Primary Health Care (PHC) for suspected or confirmed cases of COVID-19 in Brazilian municipalities, according to population size. Methodology: a cross-sectional, analytical, and exploratory approach, with 1,474 PHC managers responding to a questionnaire via Google Forms between April and September 2022. The analyzes used prevalence ratios and Poisson regression with random effects. Results: in small municipalities (sizes 1 and 2), the availability of face shields was 11% more prevalent (p<0.01), and the availability of testing facilities and staff was 8% higher (p=0.02) than in municipalities of size 3 or 4. In these locations, care in a separate ward was 35% more frequent (p<0.01), prior bed verification was 78% more common (p<0.01), and active surveillance was 28% higher (p<0.01). Symptom review every 48 hours was 52% more prevalent (p<0.01). On the other hand, the adoption of clinical protocols for flu-like syndromes was 9% lower (p=0.01). Medium-sized municipalities (3 and 4) had lower availability of aprons (p=0.03) and disinfection between visits (p<0.01), as well as worse follow-up indicators. Population size influenced the PHC response. which was more agile in small municipalities and more complex in large ones.


¹Derived from the dissertation titled Safe Surgery Saves Lives Program as a Global Challenge of the World Health Organization: overview of surgical site infection prevention measures adopted in large hospitals in Minas Gerais, presented to the Graduate Program in Nursing at the Federal University of Minas Gerais, 2019.