scholarly journals THE FAMILY HEALTH STRATEGY AND HOSPITALIZATIONS IN OLDER ADULTS IN THE NORTHEAST OF BRAZIL

2021 ◽  
Author(s):  
Natália Reis de Carvalho ◽  
Ana Luiza Carvalho Costa ◽  
Andréa Carvalho Araújo Moreira ◽  
Samir Gabriel Vasconcelos Azevedo ◽  
Naiara Teixeira Fernandes ◽  
...  
Keyword(s):  
Primary Care ◽  
Ambulatory Care ◽  
Family Health ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospitalization Rates ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

OBJECTIVE: To analyze the association between the expansion of the Family Health Strategy and hospitalizations for ambulatory care-sensitive conditions in older adults. METHODS: This ecological study was conducted from June to October 2019. The units of analysis were all states in the Northeast of Brazil, and the historical outline included the period from 2008 to 2018. Data on the coverage of the Family Health Strategy and hospitalizations were extracted from the Primary Care Information and Management System and the Hospital Information System. For the association analysis, Spearman coefficients (r) were calculated at a 95% confidence interval (p < 0.05) using STATA, version 13.0. An absolute r value above 0.5 was considered satisfactory. RESULTS: From 2008 to 2018, the Northeast Region recorded a 13.33% increase in the Family Health Strategy coverage and a 27.44% decrease in hospitalization rates. Coverage did not expand in the states of Paraíba, Rio Grande do Norte, and Sergipe; in the latter, there was also no significant reduction in hospitalization rates. There was a correlation between the expansion of the Family Health Strategy and a reduction in hospitalizations for ambulatory care-sensitive conditions in the states of Alagoas (r = −0.9636), Bahia (r = −0.9545), Ceará (r = −0.8884), and Piauí (r = −0.7000). CONCLUSIONS: The results indicate that increased coverage of the Family Health Strategy is associated with greater effectiveness of primary care. However, other intervening factors in hospitalization rates for ambulatory care-sensitive conditions should be considered, such as the health care model and socioeconomic context.

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

2014 ◽  
Vol 48 (6) ◽  
pp. 958-967 ◽  
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.

scholarly journals Conceptual and methodological aspects in the study of hospitalizations for ambulatory care sensitive conditions

2011 ◽  
Vol 16 (suppl 1) ◽  
pp. 1145-1154 ◽  
Author(s):  
Fúlvio Borges Nedel ◽  
Luiz Augusto Facchini ◽  
João Luiz Bastos ◽  
Miguel Martín-Mateo
Keyword(s):  
Health Care ◽  
Ambulatory Care ◽  
Family Health ◽  
Ambulatory Care Sensitive Conditions ◽  
Family Health Program ◽  
Hospitalization Rates ◽  
Effective Care ◽  
Methodological Aspects ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Hospitalization rates for Ambulatory Care Sensitive Conditions have been used to assess effectiveness of the first level of health care. From a critical analysis of related concepts, we discuss principles for selecting a list of codes and, taking the example of the Brazilian Family Health Program, propose a methodological pathway for identifying variables in order to inform statistical models of analysis. We argue that for the indicator to be comparable between regions, disease codes should be selected based on sensitivity and specificity principles, not on observed disease frequency. Rates of hospitalization will be determined, at a distal level, by the socio-economic environment and their effect on the social and demographic structure. Timely and effective care depends on the organization of health services, their availability and access barriers, which depend on the ways health and related technology are conceptualised and on their adherence to the biomedical model or to the Primary Health Care (PHC) principles; performance indicators of the health system will be the proximal determinants. This indicator is potentially useful for primary care evaluation. The historical reconstruction of PHC improves the analysis of the indicator variability.

A Spatial Analysis of Preventable Hospitalization for Ambulatory Care Sensitive Conditions and Regional Characteristics in South Korea

2019 ◽  
Vol 31 (5) ◽  
pp. 422-432
Author(s):  
Jinkyung Kim ◽  
Hye-Young Kang ◽  
Kwang-Soo Lee ◽  
Songhee Min ◽  
Euichul Shin
Keyword(s):  
Primary Care ◽  
Regression Analysis ◽  
Spatial Analysis ◽  
Ambulatory Care ◽  
Low Income ◽  
Ambulatory Care Sensitive Conditions ◽  
Local Regression ◽  
Hospitalization Rates ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Hospitalization rates for ambulatory care sensitive conditions (ACSCs) can indicate the accessibility of a community’s primary care. We examined regional variation in ACSC hospitalization rates and identified associated factors. ACSC hospitalization rates in the 232 districts in 2013 ranged from 4.08 to 101.53 per 1000 adults. Spatial analysis showed that none of the 24 highest rate districts were located near Seoul, whereas 80% of the 45 lowest rate districts were, suggesting health care inequality between people living near Seoul and in other areas. Regression analysis showed significantly higher ACSC hospitalization rates in districts with higher elderly (β = 0.94) and low-income populations (β = 2.25), more remote areas (β = 0.29), and more hospital beds (β = 0.03). The number of primary care clinics was negatively associated with ACSC hospitalization (β = −1.37). For these variables, geographically weighted regression analysis provided local regression coefficients, useful for developing region-specific strategies to reduce ACSC hospitalization.

scholarly journals Association between hospitalisation for ambulatory care-sensitive conditions and primary health care physician specialisation: a cross-sectional ecological study in Curitiba (Brazil)

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e015322 ◽  
Author(s):  
Marcelo P D Afonso ◽  
Helena E Shimizu ◽  
Edgar Merchan-Hamann ◽  
Walter M Ramalho ◽  
Tarcisio Afonso
Keyword(s):  
Ambulatory Care ◽  
Ecological Study ◽  
National Health System ◽  
Family Health ◽  
Care Physician ◽  
Ambulatory Care Sensitive Conditions ◽  
Cross Sectional ◽  
Family Health Strategy ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

IntroductionHospitalisation for ambulatory care-sensitive conditions (HACSCs) is frequently used as an indicator of the quality and effectiveness of primary healthcare (PHC) services around the world. The aim of the present study was to evaluate whether the PHC model (family health strategy (FHS) x conventional) and the availability of specialised PHC physicians is associated or not with total hospitalisation or HACSCs in the National Health System (SUS) of the municipality of Curitiba, Paraná state (PR), Brazil.MethodologyThis is a cross-sectional ecological study using multiple linear regression with socioeconomic and professional data from municipal health units (MHUs) between 1 April 2014 and 31 March 2015.ResultsAfter adjustment for age and sex and control of socioeconomic variables, the FHS model was associated with six fewer HACSCs a year per 10 000 inhabitants in relation to the conventional model and the availability of one family physician at each FHS model MHU per 10 000 inhabitants was associated with 1.1 fewer HACSCs for heart failure a year per 10 000 inhabitants. Basic specialists (clinicians, paediatricians and obstetrician/gynaecologists) and subspecialists showed no significant association with HACSC rates.ConclusionThese results obtained in a major Brazilian city reinforce the role of FHS as a priority PHC model in the country and indicate the potentially significant impact of specialising in family medicine on improving the health conditions of the population.

scholarly journals Hospitalizations due to primary care sensitive conditions

2019 ◽  
Vol 53 ◽  
pp. 2
Author(s):  
Ludmila Grego Maia ◽  
Luiz Almeida Da Silva ◽  
Rafael Alves Guimarães ◽  
Bruno Bordin Pelazza ◽  
Ana Cláudia Souza Pereira ◽  
...  
Keyword(s):  
Primary Care ◽  
Regression Coefficient ◽  
Pearson Correlation ◽  
Family Health ◽  
The State ◽  
Linear Regression Method ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy ◽  
Sensitive Conditions

OBJECTIVE: To evaluate the trend of hospitalizations due to primary care sensitive conditions and its relationship with the Family Health Strategy coverage. METHODS: Ecological study of time series using the records from the Hospital Information System, from 2005 to 2015, with data for the state of Goiás, Brazil. Trend analyses were performed by the generalized linear regression method of Prais-Winsten with robust variance, which allowed to verify if the trend of hospitalizations due to primary care sensitive conditions was stationary (p > 0.05), declining (p < 0.05 and negative regression coefficient), or ascending (p < 0.05 and positive regression coefficient) in each region of Goiás and for each diagnosis group, stratified by sex. Pearson correlation was used to verify the degree of association between the Family Health Strategy coverage and the rate of hospitalizations due to primary care sensitive conditions. RESULTS: Hospitalizations due to primary care sensitive conditions accounted for 1,092,070 (30.0%) of hospitalizations in Goiás. The average hospitalizations rate due to primary care sensitive conditions was statically less than the rate for other conditions in the analyzed period (167.6% against 386.2%; t = -13.18; p < 0.001). There has been a downward trend in hospitalizations trend due to primary care sensitive conditions in Goiás and in most health regions. The trends varied between sexes in the groups of causes. We observed a negative correlation between the Family Health Strategy coverage and the hospitalizations trend due to primary care sensitive conditions in the state and also in most health regions. CONCLUSIONS: Hospitalizations due to primary care sensitive conditions had a significant reduction trend over the analyzed period. Despite this progressive decrease, this rate remains high and the reduction trend was not linear for all causes. These results allow for directing public policies, while drawing a general overview of hospitalizations due to primary care sensitive conditions by sex and region in the state.

scholarly journals Identifying priorities for primary care investment in Ireland through a population-based analysis of avoidable hospital admissions for ambulatory care sensitive conditions (ACSC)

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028744 ◽  
Author(s):  
Geraldine McDarby ◽  
Breda Smyth
Keyword(s):  
Primary Care ◽  
Ambulatory Care ◽  
Integrated Care ◽  
Hospital Admissions ◽  
Acute Hospital ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital System ◽  
Bed Days ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

BackgroundIn 2016, the Irish acute hospital system operated well above internationally recommended occupancy targets. Investment in primary care can prevent hospital admissions of ambulatory care sensitive conditions (ACSCs).ObjectiveTo measure the impact of ACSCs on acute hospital capacity in the Irish public system and identify specific care areas for enhanced primary care provision.DesignNational Hospital In-patient Enquiry System data were used to calculate 2011–2016 standardised bed day rates for selected ACSC conditions. A prioritisation exercise was undertaken to identify the most significant contributors to bed days within our hospital system. Poisson regression was used to determine change over time using incidence rate ratios (IRR).ResultsIn 2016 ACSCs accounted for almost 20% of acute public hospital beds (n=871 328 bed days) with adults over 65 representing 69.1% (n=602 392) of these. Vaccine preventable conditions represented 39.1% of ACSCs. Influenza and pneumonia were responsible for 99.8% of these, increasing by 8.2% (IRR: 1.02; 95% CI 1.02 to 1.03) from 2011 to 2016. Pyelonephritis represented 47.6% of acute ACSC bed days, increasing by 46.5% (IRR: 1.07; 95% CI 1.06 to 1.08) over the 5 years examined.ConclusionsPrioritisation for targeted investment in integrated care programmes is enabled through analysis of ACSC’s in terms of acute hospital bed days. This analysis demonstrates that primary care investment in integrated care programmes for respiratory ACSC’s from prevention to rehabilitation at scale could assist with bed capacity in acute hospitals in Ireland. In adults 65 years and over, including chronic obstructive pulmonary disease patients, the current analysis supports targeting community based pulmonary rehabilitation including pneumococcal and influenza vaccination programmes in order to reduce the burden of infection and hospitalisations. Further exploration of pyelonephritis is necessary in order to ascertain patient profile and appropriateness of admissions.

Primary-Care Visits and Hospitalizations for Ambulatory-Care–Sensitive Conditions in an Inner-City Health Care System

2003 ◽  
Vol 3 (6) ◽  
pp. 324-328 ◽  
Author(s):  
John F. Steiner ◽  
Patricia A. Braun ◽  
Paul Melinkovich ◽  
Judith E. Glazner ◽  
Vijayalaxmi Chandramouli ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Inner City ◽  
Ambulatory Care ◽  
Health Care System ◽  
Ambulatory Care Sensitive Conditions ◽  
Care System ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

scholarly journals Hospitalization of older adults due to ambulatory care sensitive conditions

2014 ◽  
Vol 48 (5) ◽  
pp. 817-826 ◽  
Author(s):  
Aline Pinto Marques ◽  
Dalia Elena Romero Montilla ◽  
Wanessa da Silva de Almeida ◽  
Carla Lourenço Tavares de Andrade
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Information System ◽  
Ambulatory Care ◽  
Rio De Janeiro ◽  
The State ◽  
Ambulatory Care Sensitive Conditions ◽  
Global Rate ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

OBJECTIVE To analyze the temporal evolution of the hospitalization of older adults due to ambulatory care sensitive conditions according to their structure, magnitude and causes. METHODS Cross-sectional study based on data from the Hospital Information System of the Brazilian Unified Health System and from the Primary Care Information System, referring to people aged 60 to 74 years living in the state of Rio de Janeiro, Souhteastern Brazil. The proportion and rate of hospitalizations due to ambulatory care sensitive conditions were calculated, both the global rate and, according to diagnoses, the most prevalent ones. The coverage of the Family Health Strategy and the number of medical consultations attended by older adults in primary care were estimated. To analyze the indicators’ impact on hospitalizations, a linear correlation test was used. RESULTS We found an intense reduction in hospitalizations due to ambulatory care sensitive conditions for all causes and age groups. Heart failure, cerebrovascular diseases and chronic obstructive pulmonary diseases concentrated 50.0% of the hospitalizations. Adults older than 69 years had a higher risk of hospitalization due to one of these causes. We observed a higher risk of hospitalization among men. A negative correlation was found between the hospitalizations and the indicators of access to primary care. CONCLUSIONS Primary healthcare in the state of Rio de Janeiro has been significantly impacting the hospital morbidity of the older population. Studies of hospitalizations due to ambulatory care sensitive conditions can aid the identification of the main causes that are sensitive to the intervention of the health services, in order to indicate which actions are more effective to reduce hospitalizations and to increase the population’s quality of life.

scholarly journals Hospitalizations for cardiovascular diseases and the coverage by the family health strategy

2015 ◽  
Vol 23 (4) ◽  
pp. 611-619 ◽  
Author(s):  
Maicon Henrique Lentsck ◽  
Thais Aidar de Freitas Mathias
Keyword(s):  
Primary Care ◽  
Cardiovascular Diseases ◽  
Family Health ◽  
The State ◽  
Regional Health ◽  
Unified Health System ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy ◽  
Spearman’S Correlation

AbstractObjective: to verify the correlation between the rates of hospitalization for primary care-sensitive cardiovascular diseases and the coverage by the Family Health Strategy of residents of the State of Paraná, by regional health divisions, from 2000 to 2011.Method: ecological study developed from data of the Hospital Information System of the Brazilian Unified Health System (SUS) and the Department of Primary Care of the Ministry of Health. The rates of hospitalization for cardiovascular diseases were correlated with the annual coverage by the Family Health Strategy using Pearson's and Spearman's correlation coefficients.Result: there was a strong and negative correlation in the State of Paraná (r=-0.91; p <0.001) and in most regional health divisions, with the highest correlations observed in the Metropolitan and Toledo (r =-0.93; p<0.001) and Paranaguá (r=-0.92, p<0.001) regional health divisions.Conclusion: the results suggest that the increase in the coverage by the Family Health Strategy was an important factor for decrease in the hospitalizations for cardiovascular conditions among residents of the State of Paraná and in most regional health divisions. Other studies should be performed to analyze the factors and causes in regional health divisions where there was no correlation with increase in the Family Health Strategy.

scholarly journals Family risk as adjunct for organizing the demand for oral health service in the Family Health Strategy

2015 ◽  
Vol 44 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Henri Menezes Kobayashi ◽  
Antonio Carlos Pereira ◽  
Marcelo de Castro Meneghim ◽  
Rívea Inês Ferreira ◽  
Glaucia Maria Bovi Ambrosano
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Multinomial Logistic Regression ◽  
Family Health ◽  
Health Conditions ◽  
Family Risk ◽  
Treatment Needs ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

Introduction One of the main problems of the public health services, in which the family oral health team is included, is access by users to dental treatment in primary care, with particular reference to caries disease. Objective The aim of this study was to evaluate the relationship between family risk, for prioritization of home visits and oral health conditions, with a view to providing evidence about the first indicator for organizing the demand for oral health in the Family Health Strategy (FHS). Method The application of family health is based on Form A of the primary care information database SIAB ("Sistema de Informação de Atenção Básica"), used for registering families with the FHS. Eleven dentists examined the oral health conditions of 1165 persons (608 from 12 to 19 years; and 557 from 35 to 44 years of age), classifying them into six codes from A to F. Multinomial logistic regression was used (α=0.05) to analyze the association between family risk variables and oral health situation. Result There was significant association between family risk and presence of caries disease with treatment needs (OR: 2.08, p<0.0001). Conclusion Persons who have family risk would have twice as much chance of presenting caries disease in comparison with those without risk, corroborating the relevance of this element in organizing the demand for oral health.

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