Avaliação da assistência prestada na atenção básica aos obesos com indicação para cirurgia bariátrica nas macrorregiões de saúde da Paraíba

Abstract

INTRODUCTION: The obesity epidemic is a challenge for primary health care, since high-cost strategies are needed to face it. Bariatric surgery is a highly complex procedure and has been playing an important role in the treatment of morbid obesity, with long-term weight control by reducing the amount of food ingested or reduced nutrient absorption. OBJECTIVE: To evaluate the assistance provided in primary care to obese individuals with indication for bariatric surgery in the health macro-regions of Paraíba. MATERIALS AND METHODS: This is a cross-sectional study nested within a national population-based study entitled “Situational diagnosis of programs and actions related to the National Food and Nutrition Policy (PNAN)”. It was carried out in 642 UBS, distributed in the 3 health macro-regions of the 168 municipalities that made up the sample of this study. Data were collected through the application of a questionnaire through the online platform SurveyMonkey. For statistical analysis, data were organized by management and health macro-regions using the StatisticalPackage for the Social Sciences - SPSS version 22.0 software. To verify possible associations between the variables under study, the Chi-square test of independence and Fisher's exact test were used, considering a significance level of 5% (p<0.05). With the aid of the R statistical software, the z test was performed for two proportions (p-value<0.05) to verify possible differences between the variables by macroregions. RESULTS: This study showed two major weaknesses that primary health care in Paraíba faces when it comes to obese patients with indication for bariatric surgery. One of them is the break in the care flow of the health care network recommended by the SUS, as well as the lack of knowledge of important parts of the process of monitoring these patients by the professionals working in the UBS studied. CONCLUSION: The findings of the present study showed that it is necessary to investigate the factors that trigger such weaknesses in order to adjust public policies aimed at users with severe obesity, as well as continuing education actions aimed at professionals working in these services.