Marcos Antônio da Cunha Santos

A Gamma-Generated Logistic Distribution: Properties and Inference

SYNOPTIC ABSTRACT For any absolutely continuous random variable with cumulative distribution function G(x; θ), Zografos and Balakrishnan (2009) pioneered the generalized Γ-G(x; a, θ) family of distributions with an additional positive parameter a. We provide a comprehensive treatment of the mathematical properties of the Γ-G family when G is the logistic distribution. The Γ-logistic distribution is studied in detail by considering its moments, generating function, mean deviations, Rényi entropy, and order statistics. We use maximum likelihood for estimating the model parameters and provide the elements of the observed information matrix. A real data set is given to illustrate the use of the new model.

Saúde mental na atenção básica: uma avaliação por meio da Teoria da Resposta ao Item

OBJETIVO Determinar os itens do Programa Nacional de Melhoria do Acesso e da Qualidade da Atencao Basica que melhor avaliam a capacidade de oferta de cuidados em saude mental. METODOS Estudo transversal efetuado por meio do Modelo de Resposta Gradual da Teoria da Resposta ao Item, utilizando dados secundarios do segundo ciclo do Programa Nacional […]

Mental health in primary care: an evaluation using the Item Response Theory

ABSTRACT OBJECTIVE To determine the items of the Brazilian National Program for Improving Access and Quality of Primary Care that better evaluate the capacity to provide mental health care. METHODS This is a cross-sectional study carried out using the Graded Response Model of the Item Response Theory using secondary data from the second cycle of the National Program for Improving Access and Quality of Primary Care, which evaluates 30,523 primary care teams in the period from 2013 to 2014 in Brazil. The internal consistency, correlation between items, and correlation between items and the total score were tested using the Cronbach’s alpha, Spearman’s correlation, and point biserial coefficients, respectively. The assumptions of unidimensionality and local independence of the items were tested. Word clouds were used as one way to present the results. RESULTS The items with the greatest ability to discriminate were scheduling of the agenda according to risk stratification, keeping of records of the most serious cases of users in psychological distress, and provision of group care. The items that required a higher level of mental health care in the parameter of location were the provision of any type of group care and the provision of educational and mental health promotion activities. Total Cronbach’s alpha coefficient was 0.87. The items that obtained the highest correlation with total score were the recording of the most serious cases of users in psychological distress and scheduling of the agenda according to risk stratification. The final scores obtained oscillated between -2.07 (minimum) and 1.95 (maximum). CONCLUSIONS There are important aspects in the discrimination of the capacity to provide mental health care by primary health care teams: risk stratification for care management, follow-up of the most serious cases, group care, and preventive and health promotion actions.

Care coordination in PMAQ-AB: an Item Response Theory-based analysis

OBJETIVO Analisar a qualidade das variaveis do Programa de Melhoria do Acesso e da Qualidade da Atencao Basica para avaliar a coordenacao na atencao basica do cuidado. METODOS Estudo transversal baseado em dados de 17.202 equipes de atencao basica que participaram do Programa de Melhoria do Acesso e da Qualidade da Atencao Basica em 2012. […]

Coordenação do cuidado no PMAQ-AB: uma análise baseada na Teoria de Resposta ao Item

ABSTRACT OBJECTIVE Analyze the quality of the National Program for Primary Care Access and Quality Improvement variables to evaluate the coordination of primary care. METHODS A cross-sectional study based on data from 17,202 primary care teams that participated in the National Program for Primary Care Access and Quality Improvement in 2012. Based on the Item Response Theory, Samejima’s Gradual Response Model was used to estimate the score related to the level of coordination. The Cronbach’s alpha and Spearman’ coefficients and the point-biserial correlation were used to analyze the internal consistency and the correlation between the items and between the items and the total score. We evaluated the assumptions of unidimensionality and local independence of the items. Cloud-type word charts aided in the interpretation of coordination levels. RESULTS The Program items with the greatest discrimination in coordination level were: telephone/Internet existence, institutional communication flows, and matrix support actions. The specialists’ contact frequency with the primary care and integrated electronic medical record required a greater level of coordination among the teams. The Cronbach’ alpha was 0.8018. The institutional communication flows and telephone/Internet items had a higher correlation with the total score. Coordination scores ranged from -2.67 (minimum) to 2.83 (maximum). More communication, information exchange, matrix support, health care in the territory and the domicile had a significant influence on the levels of coordination. CONCLUSIONS The ability to provide information and the frequency of contact among professionals are important elements for a comprehensive, continuous and high-quality care.