Evaluation of primary health care by users during the COVID-19 pandemic: A cross-sectional study

Objective To evaluate the primary health care (PHC) attributes and associated factors during the COVID-19 pandemic using the perspective of users. Methods This cross-sectional, quantitative study included 422 PHC users from 96 Family Health Teams in a city in Brazil. The assessment used the Primary Care Assessment Tool (PCATool) and a structured questionnaire on the sociodemographic and epidemiological characteristics of users and basic health units (BHU). The Person's chi-square test was used to analyze the association between high overall scores in PCATool and characteristics of users and BHU. Crude and adjusted prevalence ratios (PR) with a 95% confidence interval were also calculated. Poisson regression and Rao Scott's Chi-square test were used to estimate crude PR. Results Most users were aged 30 to 39 years (26.3%), women (75.4%), registered at the BHU for over ten years (59.5%), and had incomplete secondary education (30.6%). The mean of PHC essential attributes and overall scores were low (6.10 +/- 0.81 and 5.78 +/- 0.77, respectively). "First-contact care-use" received the highest score (9.22 +/- 1.62), while "first-contact care-accessibility" received the lowest (2.82 +/- 0.90). High overall scores were associated with an average employment time of professionals (doctors and nurses) at the BHU (PR = 1.31; 95% CI 1.17-1.48; p < 0.001) and lower educational level of users (PR = 1.71; 95% CI 1.54-1.90; p < 0.001. Conclusion "First-contact care-use" was the best evaluated, while "first-contact care-accessibility" was the worst. High scores were associated with a lower educational level of users and BHU with more experienced professionals.