Care coordination in PMAQ-AB: an Item Response Theory-based analysis

• Main Authors: Miriam Francisco de Souza, Alaneir de Fatima dos Santos, Ilka Afonso Reis, Marcos Antônio da Cunha Santos, Alzira de Oliveira Jorge, Antônio Tomaz Gonzaga da Matta Machado, Eli Iola Gurgel Andrade, Mariangela Leal Cherchiglia
• Format: Article
• Language: English
• Published: Universidade de São Paulo 2017-09-01
• Series: Revista de Saúde Pública
• Subjects: Atenção Primária à Saúde; Acesso aos Serviços de Saúde; Avaliação de Serviços de Saúde; Eficiência Organizacional; Garantia da Qualidade dos Cuidados de Saúde
• Online Access: http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0034-89102017000100278&lng=en&tlng=en

ABSTRACT OBJECTIVE Analyze the quality of the National Program for Primary Care Access and Quality Improvement variables to evaluate the coordination of primary care. METHODS A cross-sectional study based on data from 17,202 primary care teams that participated in the National Program for Primary Care Access and Quality Improvement in 2012. Based on the Item Response Theory, Samejima’s Gradual Response Model was used to estimate the score related to the level of coordination. The Cronbach’s alpha and Spearman’ coefficients and the point-biserial correlation were used to analyze the internal consistency and the correlation between the items and between the items and the total score. We evaluated the assumptions of unidimensionality and local independence of the items. Cloud-type word charts aided in the interpretation of coordination levels. RESULTS The Program items with the greatest discrimination in coordination level were: telephone/Internet existence, institutional communication flows, and matrix support actions. The specialists’ contact frequency with the primary care and integrated electronic medical record required a greater level of coordination among the teams. The Cronbach’ alpha was 0.8018. The institutional communication flows and telephone/Internet items had a higher correlation with the total score. Coordination scores ranged from -2.67 (minimum) to 2.83 (maximum). More communication, information exchange, matrix support, health care in the territory and the domicile had a significant influence on the levels of coordination. CONCLUSIONS The ability to provide information and the frequency of contact among professionals are important elements for a comprehensive, continuous and high-quality care.