Association Between Imposition of a Maintenance of Certification Requirement and Ambulatory Care–Sensitive Hospitalizations and Health Care Costs

OBJECTIVE: To describe the rate of ambulatory care sensitive hospitalizations in groups of cities according to population size and to analyze its association with the coverage of the Family Health Strategy after the implementation of the Master Plan for Primary Health Care in Minas Gerais, Brazil. METHODS: This is an ecological study with 452 cities grouped according to population size, with data from 2004 to 2007 and 2010 to 2013. We used the Kolmogorov-Smirnov test to verify the distribution of the data in the groups. We used the Wilcoxon test for paired data or the paired Student’s t-test to compare the rate of ambulatory care sensitive hospitalizations before and after the Master Plan for Primary Health Care. We used the simple linear regression test to analyze the association between variables. We performed statistical analyses using the Statistical Package for the Social Sciences, with a significance level of 5%. RESULTS: The rate of ambulatory care sensitive hospitalizations decreased significantly after the Master Plan for Primary Health Care in the large and mid-sized groups (p < 0.05). There were positive correlations between coverage with Family Health Strategy and the rate of ambulatory care sensitive hospitalizations in the mid-sized and large groups (p < 0.05). CONCLUSIONS: Actions were carried out to implement the Master Plan for Primary Health Care. However, more investments are needed to improve the effectiveness of the Primary Health Care, with permanent confrontation of complex issues that affect the quality of services, which can lead to a significant reduction of the rates of ambulatory care sensitive hospitalizations.

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Association Between Cognitive Function and 3 Month Health Care Costs Among Patients Initiating an Antidepressant for Depressive Disorder in an Ambulatory Care Setting

Value in Health ◽

10.1016/j.jval.2013.08.1388 ◽

2013 ◽

Vol 16 (7) ◽

pp. A544

Author(s):

J.L. Kurlander ◽

V. Walker ◽

B. Essoi ◽

J. Samp ◽

K.S. Akhras ◽

...

Keyword(s):

Health Care ◽

Cognitive Function ◽

Depressive Disorder ◽

Ambulatory Care ◽

Health Care Costs ◽

Care Setting ◽

Ambulatory Care Setting ◽

Care Costs

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Hospitalizations for ambulatory care-sensitive conditions, Minas Gerais, Southeastern Brazil, 2000 and 2010

Revista de Saúde Pública ◽

10.1590/s0034-8910.2014048005232 ◽

2014 ◽

Vol 48 (6) ◽

pp. 958-967 ◽

Cited By ~ 5

Author(s):

Rita Maria Rodrigues-Bastos ◽

Estela Márcia Saraiva Campos ◽

Luiz Cláudio Ribeiro ◽

Mauro Gomes Bastos Filho ◽

Maria Teresa Bustamante-Teixeira

Keyword(s):

Health Care ◽

Ambulatory Care ◽

Family Health ◽

Hospitalization Rates ◽

Primary Health ◽

Health Strategy ◽

The Family ◽

Family Health Strategy ◽

Ambulatory Care Sensitive Hospitalizations ◽

Ambulatory Care Sensitive

OBJECTIVE To analyze hospitalization rates and the proportion of deaths due to ambulatory care-sensitive hospitalizations and to characterize them according to coverage by the Family Health Strategy, a primary health care guidance program. METHODS An ecological study comprising 853 municipalities in the state of Minas Gerais, under the purview of 28 regional health care units, was conducted. We used data from the Hospital Information System of the Brazilian Unified Health System. Ambulatory care-sensitive hospitalizations in 2000 and 2010 were compared. Population data were obtained from the demographic censuses. RESULTS The number of ambulatory care-sensitive hospitalizations declined from 20.75/1,000 inhabitants [standard deviation (SD) = 10.42) in 2000 to 14.92/thousand inhabitants (SD = 10.04) in 2010 Heart failure was the most frequent cause in both years. Hospitalizations rates for hypertension, asthma, and diabetes mellitus, decreased, whereas those for angina pectoris, prenatal and birth disorders, kidney and urinary tract infections, and other acute infections increased. Hospitalization durations and the proportion of deaths due to ambulatory care-sensitive hospitalizations increased significantly. CONCLUSIONS Mean hospitalization rates for sensitive conditions were significantly lower in 2010 than in 2000, but no correlation was found with regard to the expansion of the population coverage of the Family Health Strategy. Hospitalization rates and proportion of deaths were different between the various health care regions in the years evaluated, indicating a need to prioritize the primary health care with high efficiency and quality.

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Teaching Quantitative Approaches to the Use of Diagnostic Tests and Procedures

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300011715 ◽

1987 ◽

Vol 3 (1) ◽

pp. 27-38

Author(s):

Robert J. Panzer ◽

Paul F. Griner

Keyword(s):

Health Care ◽

Ambulatory Care ◽

Health Care Costs ◽

Diagnostic Tests ◽

Medical Technology ◽

Hospital Costs ◽

Substantial Proportion ◽

Total Hospital ◽

Diagnostic Technology ◽

Care Costs

Pressures to contain health care costs have challenged physicians to be more discriminating in the use of medical technology. Particularly important is the need to apply diagnostic technology selectively since the costs of diagnostic tests and procedures may account for as much as one quarter of total hospital costs and a smaller but substantial proportion of ambulatory care costs.

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