Evaluation of the performance of Primary Health Care Services: experience in rural municipalities in Santander, Colombia

Public health services performance in Primary Health Care was evaluated in six municipalities from Santander, Colombia, after the development of a Primary Health Care program at the state level. A cross-sectional, comparative study design was developed using a rapid assessment methodology, designed by Starfield. Patients, professionals and decision-makers were interviewed in three municipalities with higher development of the program and compared with three municipalities with lower development, all six predominantly rural areas. Propensity scores were calculate to equalize basal characteristics of groups being compared and multivariate analysis was used to evaluate the effect of the level of development of the program in the global performance index by patients. Higher total scores in the global performance index were found in patients in municipalities with higher development programs. Family-focus, Community orientation and Access were dimensions with lower scores. Higher model development was associated with higher performance index scores by patients. In spite of higher primary health care model development was associated with best global performance scores, access, family focus and community orientation are attributes less developed.