Determinantes da força da atenção primária à saúde nas capitais brasileiras:

Authors

DOI:

https://doi.org/10.20397/2177-6652/2025.v25i1.3146

Keywords:

Atenção Primária à Saúde;, Avaliação de Serviços de Saúde, Determinantes Sociais da Saúde;, Modelagem de Equações Estruturais, Qualidade da Assistência à Saúde

Abstract

Introduction: Primary Health Care (PHC) is essential for the organization of health systems, improving health indicators and reducing inequalities. However, the relationship between social determinants of health and PHC strength still lacks empirical evidence. Objective: To analyze the determinants of PHC in Brazilian capitals from 2015 to 2019. Methods: A cross-sectional ecological study using 88 explanatory indicators organized into nine dimensions and 10 PHC strength indicators, extracted from the 2019 National Health Survey. Structural Equation Modeling was applied using the Partial Least Squares method. Results: Significant variations in PHC scores were observed among capitals, with Florianópolis, Curitiba, Teresina, Recife, and Cuiabá showing the highest scores, while Goiânia, Belém, Rio de Janeiro, and Fortaleza had the lowest. The structural analysis identified Epidemiological Determinants, Health Care Network, Governance of Primary Care Services, Environmental Determinants, and Socioeconomic Determinants as the main factors associated with PHC strength, with the latter showing an inverse relationship. Economic conditions of PHC and care capacity were not significant predictors, suggesting that governance and network integration play a more decisive role than resource availability alone. Conclusion: PHC attributes do not contribute uniformly to PHC strength, and the overall PCATool score may not fully capture these differences. The dimensions most strongly associated with PHC strength should guide public policies aimed at strengthening PHC attributes in Brazil. Further studies are recommended to confirm these findings.

Author Biographies

César Macieira, Universidade Federal de Minas Gerais

Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

Gregório Victor Rodrigues, Universidade Federal de Minas Gerais

Consultor Independente em Ciência de Dados

Tarcísio Afonso, , Fundação Cultural Dr Pedro Leopoldo, Pedro Leopoldo, Brasil.

professor Fundaçao Pedro Leopoldo

Veneza Berenice de Oliveira, Universidade Federal de Minas Gerais

Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

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Published

2025-03-08

How to Cite

Afonso, M. P. D. ., Macieira, C., Rodrigues, G. V., Afonso, T., & Oliveira, V. B. de. (2025). Determinantes da força da atenção primária à saúde nas capitais brasileiras: . Revista Gestão & Tecnologia, 25(1), 273–305. https://doi.org/10.20397/2177-6652/2025.v25i1.3146

Issue

Vol. 25 No. 1 (2025)

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ARTIGO

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