Factors associated with the duration and the quality of pharmaceutical dispensing in a primary healthcare facility from Belo Horizonte, Brazil

The measures of productivity used in the health sector do not reflect their specificities. A similar vision to the industrial design is prevalent, because there is a valorization of the number of procedures per unit of time. In the case of the pharmaceutical dispensing, the literature reports problems in the work process and in the quality of care related to the requirements of productivity. It was observed the pharmaceutical dispensing and collected the following data: number of patients attended; number and type of drugs demanded; dispensing time and if treatment-guidelines were given to the patients. The time and the guidelines giving were considered the dependent variables in the analysis of 105 consultations. For evaluating the association between the dependent and independent variables, it was used the chi-square test with correction of continuity (p ≤ 0.05) and the calculation of the 95% confidence interval. The frequency of guidelines giving was related to the number of consultations (p = 0003). The days with bigger flow of patients increased by 4.4 times the chance of not giving treatment guidelines (95% CI 1,7-11,5). The reduction of the dispensing time was associated with type (p = 0001) and number (p <0001) of drugs demanded and with the increased flow of patients (p <0001). Consultations without guidelines giving, was also related to the reduction of the dispensing time (95% CI 3.0 - 17.3). An increased flow of patients generates an acceleration of care, reducing the frequency of treatment guidelines and the dispensing duration. There is a loss of quality of care when the time requirements overcome the workers response capacity. The measures of productivity based on the number of procedures do not reflect the reality of services. It is suggested to integrate the knowledge about the dispensing activity and the management design of health systems.