• Patricia S Chueiri, Marcelo Rodrigues Gonçalves, Lisiane Hauser, Lucas Wollmann, Sotero Serrate Mengue, Rudi Roman, Milena Rodrigues Agostinho Rech, Marcelo de Araújo Vianna Soares, Jamily Pertile, and Erno Harzheim.
• School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo.
• Fam Pract. 2020 Oct 19; 37 (5): 648-654.

BackgroundPrimary health care (PHC) delivery in Brazil has improved in the last decades. However, it remains unknown whether the Family Health Strategy teams are meeting the health needs of the population.ObjectivesTo describe the reasons for encounter (RFEs) in PHC in Brazil and to examine variations in RFEs according to sex, age and geographic region.MethodsThis descriptive study is part of a national cross-sectional study conducted in 2016. The sample was stratified by the number of PHC physicians per geographic region. Physicians who had been working for at least 1 year in the same PHC unit were included. For every participating physician, 12 patients aged ≥18 years who had attended at least two encounters were included. Patients were asked about their RFEs, which were classified according to the International Classification of Primary Care.ResultsIn 6160 encounters, a total of 8046 RFEs were coded. Seven reasons accounted for 50% of all RFEs. There was a high frequency of codes related to test results, medication renewal and preventive medicine. RFEs did not vary significantly by sex or geographic region, but they did by age group (P < 0.001). The rates of prescriptions, requests for investigations and referrals to specialized care were 71.1%, 42.8%, and 21.3%, respectively.ConclusionThis novel study opened the 'black box' of RFEs in PHC in Brazil. These findings can contribute to redefining the scope of PHC services and reorienting work practices in order to improve the quality of PHC in Brazil.© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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