Quality of home visits by community health workers in primary care and associated factors.
Marciane Kessler, Elaine Thumé, Luiz Augusto Facchini and 2 others
PMID 39607220WHAT IT FOUND
Just 51.9% of home visits by community health workers met the study's full set of quality actions.
Teams that defined catchment areas, monitored health indicators, assessed user satisfaction, and used risk criteria were more likely to have adequate visits.
Key findings
01Among 112,741 users who said they received a home visit, 51.9% reported that the community health worker carried out all five quality actions.
02Adequate visits were more likely in teams that defined a catchment area, monitored and analysed health indicators, assessed user satisfaction, used risk and vulnerability criteria, and had no undiscovered population.
03After adjustment, visit quality did not differ significantly by sex, age, or skin colour, but was higher among users with hypertension and diabetes and among users with someone at home who had walking difficulties.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Teams and municipalities joined the national evaluation voluntarily, so teams with poor or precarious working conditions may be absent, and true home visit quality could be worse than reported. Users were selected from people attending the health centre on the day of the visit, so the sample may not represent people who did not attend. The outcome was based on users' yes/no reports of five activities, not a clinical outcome or observed visit. The study did not test whether improving team routines changes the quality or health effects of home visits.
Declared interests
The authors declared no conflicts of interest. The study was supported by Brazil's Ministry of Health, grant SICONV 760463/11.
The easy way to misread this
Do not read the higher quality in teams that defined catchment areas, monitored indicators, assessed user satisfaction, and used risk criteria as proof that changing these routines will improve visits. The study was cross-sectional and based on users' reports, so it found associations, not tested effects.