Impacto da articulação de saúde da pessoa idosa na atenção primária à saúde com foco na implementação da avaliação multidimensional: um ensaio comunitário

Abstract

Population aging poses challenges to Primary Health Care (PHC), requiring organizational adaptations to ensure quality care for the elderly population. In this context, the Multidimensional Assessment of the Elderly (AMD) emerges as an essential tool for identifying demands and planning care. However, its implementation faces challenges. Objective: This study aims to verify whether, in Health Units with readiness for change, the presence of the elderly health coordinator influences the number of AMDs performed and recorded in the PHC electronic medical records. Methodology: Two studies were conducted: the first assessed commitment and effectiveness for readiness for change in PHC units in São Carlos-SP, using the ORIC-BR instrument. The second analyzed the impact of the coordinator's presence on the execution and recording of AMDs through a community trial comparing the Control Group (CG) and the Intervention Group (IG). Results: The results indicated that only 8 of the 28 units that agreed to participate in the study showed readiness for change. The analysis of ORIC-BR responses revealed significant variations between managers and professionals, suggesting a misalignment in their perception of the organizational capacity to implement changes. In the community trial, it was observed that the units with a health coordinator recorded a significant increase in the number of AMDs performed and registered in the Citizen’s Electronic Health Record (PEC). A statistically significant interaction was identified between the group and the assessment moment (p < 0.001), indicating that the IG showed a significant improvement in the post-intervention period compared to the pre-intervention period (p < 0.001), in addition to recording more AMDs than the CG in the post-intervention period (p < 0.001). Conclusion: The application of ORIC-BR proved to be a useful tool for diagnosing organizational readiness, assisting managers in identifying units more prepared for the implementation of new practices. Additionally, the presence of the elderly health coordinator proved to be a viable strategy to strengthen AMD in PHC, promoting greater integration among professionals and enhancing the effectiveness of assessments. It is concluded that the articulation between different levels of care and the training of teams are key determinants for the success of AMD and, consequently, for improving elderly care services.