Rev Panam Salud Publica. 2026 Sep 23;50:e94. doi: 10.26633/RPSP.2026.94. eCollection 2026.
ABSTRACT
OBJECTIVE: To analyze the implementation status of the HEARTS initiative in Chile's primary healthcare network based on the results of self-assessment of quality in the domains fidelity, feasibility, acceptability, and effectiveness.
METHODS: A descriptive, cross-sectional study based on self-reported quality data collected between July and December 2025 from primary care teams implementing HEARTS. Of the 544 primary care centers that reported active implementation, 511 (93.9%) completed the self-assessment; relative to the national total of 602 primary care centers, coverage was 84.9%. A total of 6,233 staff members participated. The database was closed and validated on 31 March 2026, following a review of the completeness, consistency, and consolidation of reports available on the DHIS2 HEARTS platform. The domains fidelity, feasibility, acceptability, and effectiveness were evaluated.
RESULTS: The fidelity domain achieved a maturity index of 15.01/21, corresponding to level 4. Gaps were identified in treatment intensification by non-physician healthcare workers (13.2%, level 1) and in continuity of care for individuals at high cardiovascular risk (59.1%, level 3). Feasibility was 93.0%, and acceptability was 93.5%. The lowest acceptability was observed for intensification of pharmacological treatment by nurses under supervision and according to protocol (65%). The performance index scored 1.0 out of 4.0, corresponding to the "incipient" category.
CONCLUSIONS: Implementation shows advances in relation to processes, while coverage and monitoring results continue to lag behind. These findings support the need to strengthen the quality of record-keeping, longitudinal follow-up, protocol-based redistribution of tasks within the current regulatory framework, and the provision of tailored technical assistance to regions with lower maturity.
PMID:42781564 | PMC:PMC13599984 | DOI:10.26633/RPSP.2026.94