Beyond headcounts: a new risk-weighted model to qualify work in Primary Health Care – A computational simulation study
DOI:
https://doi.org/10.33448/rsd-v14i10.49656Keywords:
Community Health Workers, Primary Health Care, Risk Stratification, Workload, Health Equity.Abstract
The dimensioning of the Community Health Agent's (CHA) territory, based on a quantitative ceiling, generates overload and inequities by ignoring the complexity of different social and health realities. This article proposes and evaluates the ÍCARO (Operational Risk-Load Index), an innovative theoretical model aimed at replacing headcounts with a metric of actual workload. Through a theoretical essay with computational simulation, two calibrations of the model (ÍCARO-1 and ÍCARO-2) were tested, both integrated with the Coelho & Savassi family risk classification and set to a 750-point target. A total of 10,000 micro-areas with demographic profiles from Porto Velho-RO (IBGE) were simulated, revealing that a CHA's coverage capacity can vary drastically from 455 to 964 people to maintain an equitable workload. It is concluded that the ÍCARO model is not just a fairer alternative, but a strategic management tool that allows managers to make evidence-based decisions, qualify the work in Primary Health Care, and effectively operationalize the principle of equity.
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Copyright (c) 2025 Flávio Salomao-Miranda, Nataska Wanssa, Karina Gerhardt Bianco Silva, Gabriella Deodato Batista, Gabriel Campos Emídio
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