Admission of alumni from Multiprofessional Residency Programs into the SUS

Flor, Taiana Brito Menêzes; Miranda, Nirond Moura; Marinho, Cristiane da Silva Ramos; Pinheiro, Josilene Maria Ferreira; Sette-de-Souza, Pedro Henrique; Noro, Luiz Roberto Augusto

doi:10.11606/s1518-8787.2021055003347

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Original Article • Rev. Saúde Pública 55 • 2021 • https://doi.org/10.11606/s1518-8787.2021055003347 copy

Admission of alumni from Multiprofessional Residency Programs into the SUS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

The Multiprofessional Health Residency Programs (PRMS) were set up as a strategy for training workforce for the Brazilian Unified Health System (SUS).

OBJECTIVE:

To investigate the proportion of alumni from Primary Health Care Multiprofessional Residency Programs admitted into the SUS and associated factors.

METHODS:

This is a sectional study developed with alumni from Primary Health Care Multiprofessional Residency Programs from all over Brazil, encompassing the period from 2015 to 2019. Participants answered an online questionnaire with general personal information, admission into stricto sensu graduate school, the labor market and, specifically, the SUS. We applied Pearson's chi-square test for bivariate analyses and Poisson's regression for multiple analysis.

RESULTS:

A total of 365 alumni from Programs from all Brazilian regions participated in the study. Of those, 80.2% reported entry into the labor market and 47.9% reported being employed in the SUS. Admission into the SUS has been associated with the professions that make up the Reference Team for Primary Health Care (PHC) (PR = 1.87; 95% CI 1.54–2.28) and non-admission into stricto sensu graduate programs (PR = 0.77; 95% CI 0.61–0.97). Regarding admission characteristics, the PHC scenario (47.4%) and work focused on health care (84.9%) were prevalent. Almost 40% of alumni who entered the SUS are working with unstable contracts. Besides, being a residency alumnus is often undervalued in recruitment (56.9%). Among those admitted into the SUS, 8.7% reported being selected to work in the Covid-19 pandemic effort.

CONCLUSIONS:

The results of this study reinforce the need for a policy to encourage the maintenance, creation and valorization of the PRMS. They also warn about the possibility that admission into the SUS for workers is increasingly difficult due to the current underfunding of the health system.

DESCRIPTORS:
Patient Care Team; Non-medical Boarding School; Work Status; Primary Health Care; Unified Health System

	Records		Respondents		Admission into the SUS
	n	%	n	%	n	%
North	74	6.4	21	5.8	7	33.3
Northeast	837	72.2	263	72.1	135	51.3
Midwest	32	2.8	11	3.0	3	27.3
Southeast	136	11.7	37	10.1	22	59.5
South	80	6.9	33	9.0	8	24.2
Brazil	1,159	100.0	365	100.0	175	47.9

Variables		Total		Admission into the SUS				Not adjusted		Adjusted
		Total		Yes		No		Not adjusted		Adjusted
		n	%	n	%	n	%	p^a a Pearson's chi-square test.	PR (95% CI)^b b Number 1 signals the reference category.	p^c c Poisson's regression.	PR (95% CI)
Age (years)
	< 30	198	54.2	91	46.0	107	54.0	0.408	1
	≥ 30	167	45.8	84	50.3	83	49.7		1.09 (0.88–1.36)	–	–
Gender
	Female	297	81.8	144	48.5	153	51.5	0.824	1.03 (0.78–1.37)	–	–
	Male	66	18.2	31	47.0	35	43.0		1
Color
	White and yellow	157	43.3	69	43.9	88	56.1	0.156	1
	Black, brown and indigenous	206	56.7	106	51.5	100	48.5		1.17 (0.94–1.46)	–	–
Profession
	Reference team	116	31.8	81	69.8	35	30.2	< 0.001	1.85 (1.52–2.26)	< 0.001	1.87 (1.54–2.28)
	Support team	249	68.2	94	37.8	155	62.2		1
Place of program
	Capital city	104	28.5	51	49.0	53	51.0	0.792	1
	Countryside	261	71.5	124	47.5	137	52.5		0.97 (0.77–1.22)	–	–
Admission of stricto sensu graduate alumni
	Yes	125	34.2	51	40.8	74	59.2	0.049	0.79 (0.62–1.00)	0.030	0.77 (0.61–0.97)
	No	240	65.8	124	51.7	116	48.3		1

Variables		n	%
Selection type (n = 173)
	Public tender	73	42.2
	Selection process	64	37.0
	Hiring via cooperatives	13	7.5
	Appointed official	10	5.8
	Contract	9	5.2
	Other	4	2.3
Differentiation of title scores for specialization in residency format (n = 167)
	Yes	72	43.1
	No	95	56.9
Employment relationship (n = 173)
	Hired employee	32	18.5
	Civil servant	67	38.7
	Scholar	14	8.1
	Appointed official	9	5.2
	Temporary contract	47	27.2
	Other	4	2.3
Time spent between completion of residency and start of work in the SUS (n = 170)
	Up to 6 months	107	62.9
	From 7 months to 1 year	22	12.9
	More than 1 year	41	24.1
Level of attention (n = 173)
	Primary care	82	47.4
	Medium complexity	25	14.5
	High complexity	27	15.6
	Primary care and medium complexity	10	5.8
	Primary care and high complexity	6	3.5
	Medium complexity and high complexity	7	4.0
	Three levels of attention	3	1.7
	Other context	13	7.5
Characterization of the professional activity performed (n = 172)^a a Exhaustive categorical variable.
	Health care	146	84.9
	Health management	32	18.6
	Health surveillance	21	12.2
	Health education	28	16.3
	Preceptorship	25	14.5
Perceived contribution of residency training for work (n = 172)
	Yes	167	97.1
	No	5	2.9
Admission by selection for Covid-19 pandemic effort (n = 172)
	Yes	15	8.7
	No	157	91.3

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[1] Correspondence: Taiana Brito Menêzes Flor, Rua dos Pintassilgos, 70, Apto 1004ᵃ - Pitimbu 59067-300 Natal, RN, Brasil. E-mail: taiana.flor@ufrn.br