Ferramentas de gestão do cuidado na Atenção Primária de municípios de pequeno porte do Paraná: Care management tools in primary health care in small municipalities in the state of Paraná

Lucélia Justino Borges; Silvano Coutinho da Silva; Mathias Roberto Loch

doi:10.17765/2176-9206.2025v18e13112

Authors

Lucélia Justino Borges Federal University of Paraná https://orcid.org/0000-0002-0142-3641
Silvano Coutinho da Silva Midwest State University https://orcid.org/0000-0002-5398-4352
Mathias Roberto Loch State University of Londrina https://orcid.org/0000-0002-2680-4686

DOI:

https://doi.org/10.17765/2176-9206.2025v18e13112

Keywords:

Care Management Tools, Primary Health Care, Small Municipalities

Abstract

The objective was to identify the use of health care management tools by Primary Health Care teams in small municipalities in the State of Paraná. Participants were 797 health professionals, predominantly women (703), who answered an online questionnaire on sociodemographic characteristics, professional performance, and care management tools, which were analyzed descriptively and using the Chi-square test. Home visits (73.1%) and matrix support (63.2%) were the most frequently reported tools. Nursing technicians, psychologists, and dental surgeons make frequent use of matrix support. Home visits were frequent for agents fighting endemic diseases, community health agents, nurses, and physicians. Shared consultations were commonly conducted by oral health technicians, and case discussions were frequently held by psychologists and nurses. Longer experience within the health unit was associated with the implementation of body practice/physical activity groups (p=0.03), while stable employment was linked to a higher incidence of shared consultations (p=0.01). In small municipalities in Paraná, home visits and matrix support were the predominant care management tools utilized by Primary Health Care professionals. In addition, both longer experience and stable employment were important factors associated with their use.

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Author Biographies

Lucélia Justino Borges, Federal University of Paraná

Professor at the Department of Physical Education at the Federal University of Paraná. He holds a degree in Physical Education from the Federal University of Uberlândia; a doctorate and a master's degree in Physical Education from the Federal University of Santa Catarina. He is a member of the Research Group on Environment, Physical Activity and Health and of the EpiFloripa Research Group: Living conditions and health of adults and elderly people in Florianópolis. He is a member of the refereeing team of the Brazilian Volleyball Confederation and the Paraná Volleyball Federation. He has experience in the area of Physical Education, working mainly on the following topics: physical activity related to health; physical activity and aging; promotion of physical activity in Primary Care.

Silvano Coutinho da Silva , Midwest State University

He holds a degree in Physical Education (1994) and a specialization in Physical Education in Elementary and High School (1996) from the State University of Londrina. He completed his master's degree (2005) and doctorate (2011) in Public Health at the Ribeirão Preto School of Nursing, University of São Paulo. He completed a postdoctoral internship at the Ribeirão Preto School of Nursing (USP) and is an adjunct professor in the Department of Physical Education at the State University of Centro-Oeste (UNICENTRO). His research topics include the role of Physical Education professionals in Primary Health Care and body practices for health promotion.

Mathias Roberto Loch, State University of Londrina

Professor at the State University of Londrina since 2006, and is currently Associate Professor B. He holds a full degree in Physical Education (2003) and a master's degree in Physical Education (2006) from the Federal University of Santa Catarina. He holds a PhD in Public Health from the State University of Londrina (2013), having completed his doctoral internship in the Department of Preventive Medicine and Public Health at the Autonomous University of Madrid. He is a professor in the Department of Physical Education at the State University of Londrina, where he served as coordinator of the Physical Education course - bachelor's degree (2008-2009). He has experience in the areas of Physical Education and Public Health. He has studied especially the following topics: a) determinants of health-related behaviors; b) inequalities and inequities in health; c) conceptual aspects of Health Promotion; d) professional training in the health area for interprofessional work; and e) interfaces between Public Health and Physical Education. He is a founding member of the Brazilian Society of Physical Activity and Health (he was vice-president in the 2013-2015 administration and Scientific Director in the 2016-2017 administration) and of the Brazilian Association of Teaching Physical Education for Health (Abenefs, where he was first secretary, was part of the Ethics Council and was a representative in the Technical Chamber for Primary Care, Family and Community Health, Public Health of the National Commission for Multiprofessional Residency in Health). He was a member of the Abrasco Epidemiology Commission (2021-2022). He worked for over 10 years as a tutor of the Multiprofessional Residency in Family Health at the State University of Londrina, where he currently teaches in the bachelor's degree in Physical Education and in the Postgraduate Program in Public Health (permanent professor and holding the position of vice-coordinator).

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Care management tools in primary health care in small municipalities in the state of Paraná