The Rio de Janeiro Municipality's Services Portfolio and Health Actions in Primary Care in Brazil

This study aimed to identify the provision of actions and procedures by family health teams (FHSt), based on Rio de Janeiro Municipality's (MRJ) Health Services Portfolio (HSP) and the main factors associated with this provision, in the different population strata. Data from the National Program for Improving Access and Quality of Primary Healthcare were used and implemented at the national level into 17,202 FHSts from June to September 2012. Outcome variables were "FHSt belonging to MRJ" and "FHSt providing all nine CS-MRJ procedures". Uni-, bi- and multivariate analysis were performed. A better performance of the MRJ in relation to other major urban centers (EP6#) (p<5%) was noted in 10 of the 14 health actions analyzed. The electronic medical record showed a level of deployment in MRJ's FHSts of 96%, contrasting with 34% in the EP6# and 14% in Brazil. Both the MRJ and EP6# evidenced low supply of mental health services (about 56%). While the supply of low-complexity procedures was a major problem in large cities, the supply of health actions in the different health care lines was a larger problem in small municipalities. Overall, the MRJ showed better performance when compared to the average of large municipalities. The health service portfolio appeared to be an important management tool.