Evaluation of the reference and counter-reference system based on the responses of the Primary Care professionals in the first External Evaluation cycle of PMAQ-AB in the state of Paraíba

In this work, are analyzed the organization, coordination and assistance of the health care networks in the state of Paraíba, Brazil, based on the data obtained from the 1st cycle of the external evaluation of the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB). It was carried on a cross-sectional study and the data were descriptively analyzed by its absolute and percentage values. It was concluded that there are weaknesses in the integration of the health care network in the state of Paraíba/Brazil concerning the planning and definition of the flow, especially in counter-reference which may compromise the integrity and the role of primary care in order to manage public care and health network.

本研究基于巴西初级保健可及性与质量改善国家计划（National Program for Access and Quality Improvement in Primary Care, PMAQ-AB）首轮外部评估所获取的数据，对巴西帕拉伊巴州医疗保健网络的组织架构、协同运作与服务支撑情况展开分析。本研究采用横断面研究设计，通过绝对数值与百分比数值对数据进行描述性分析。研究结果显示，巴西帕拉伊巴州医疗保健网络在整合层面存在短板，尤其在转诊流程的规划与界定环节，尤其是逆向转诊方面，这可能损害基层医疗的服务完整性与职能发挥，进而影响公共医疗与卫生健康网络的运营管理。