einstein (São Paulo). 14/ago/2026;24(spe3):eAO2528.
First-contact access from the perspective of users of primary health care: an evaluation in family and oral health teams
DOI: 10.31744/einstein_journal/2026AO2528
Highlights
■ Utilization scores were higher than accessibility scores in both family health teams and oral health teams.
■ The performance of accessibility was predominantly low in both service modalities.
■ Among oral health teams users, few differences were observed across participant characteristics.
■ Utilization was higher among older, vulnerable, and chronically ill family health teams users.
ABSTRACT
Objective:
In this study, we aimed to evaluate the primary health care attribute of first-contact access from the perspective of users of family and oral health teams in São Paulo, Brazil.
Methods:
A cross-sectional study was conducted at 12 basic health units between January and November 2021. The adult versions of the Primary Care Assessment Tool (PCATool-Brazil) and PCATool-Oral Health were used to assess first-contact access through its two components of utilization and accessibility.
Results:
In total, 537 individuals participated, including 129 users of oral health teams and 408 users of family health teams. In both groups, utilization scores were higher than accessibility scores. Among users of oral health teams, the mean scores were 8.08 for utilization and 4.37 for accessibility; among users of family health teams, the corresponding scores were 8.43 and 3.80. For oral and family health teams, high performance for utilization was observed in 85.37% and 87.53% of users, whereas low performance for accessibility was observed in 95.08% and 97.70% of users, respectively. Few differences in participant characteristics were observed among users of oral health teams, with higher utilization scores noted among those without private health insurance. Regarding users of family health teams, higher utilization scores were observed among older adults, retirees, or pensioners; beneficiaries of social programs; those without private health insurance; and those with hypertension and or diabetes. For accessibility, higher scores were observed among men, older adults, and retirees or pensioners.
Conclusion:
Overall, utilization was satisfactory and accessibility was unsatisfactory in both family and oral health teams. Primary health care services were recognized as a usual source of care, but organizational barriers to timely access remain, especially in oral health care. These findings highlight the need to strengthen accessibility in primary health care, particularly through organizational strategies aimed at improving timely access to care.
[…]
