Association between hospitalizations for sensitive conditions and quality of primary care
ABSTRACT OBJECTIVE To analyze the association between municipal rates of ambulatory care sensitive conditions (ACSC) hospitalization and the quality of primary health care (PHC), socioeconomic, and demographic variables and those related to local characteristics of the health system from 2010 to 20...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2023-11-01
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| Series: | Revista de Saúde Pública |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102023000100271&tlng=pt |
| _version_ | 1797628814288748544 |
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| author | Filipe Malta dos Santos César Macieira Antônio Thomaz Gonzaga da Matta Machado Elis Mina Seraya Borde Alzira de Oliveira Jorge Bruno Abreu Gomes Alaneir Fatima dos Santos |
| author_facet | Filipe Malta dos Santos César Macieira Antônio Thomaz Gonzaga da Matta Machado Elis Mina Seraya Borde Alzira de Oliveira Jorge Bruno Abreu Gomes Alaneir Fatima dos Santos |
| author_sort | Filipe Malta dos Santos |
| collection | DOAJ |
| description | ABSTRACT OBJECTIVE To analyze the association between municipal rates of ambulatory care sensitive conditions (ACSC) hospitalization and the quality of primary health care (PHC), socioeconomic, and demographic variables and those related to local characteristics of the health system from 2010 to 2019. METHOD Ecological time series study in Brazilian municipalities analyzing the correlation of ACSC hospitalization rates with PHC quality measured by the three cycles of the Primary Care Access and Program for improving primary care access and quality (PMAQ-AB). The study included municipalities whose teams participated in 80% or more of at least two PMAQ-AB cycles. The correlation between standardized ACSC hospitalization rates and PHC quality and other variables was analyzed. Spearman’s test was used between the response variable and numerical explanatory variables. Generalized equations estimation was used as a multivariate model associating ACSC hospitalization rates with the other variables over the years. RESULTS A total of 3,500 municipalities were included in the models. The quality of PHC (PMAQ-AB score) showed an inverse association with the variation in ACSC hospitalization rates. Hospitalization rates fell by -2% per year every ten-point increase in the PMAQ-AB score, adjusted by the remaining variables. A one-unit increase in the beds per 1,000 inhabitants variable had an impact of approximately +6.4% on ACSC hospitalization rates. Regarding population size, larger municipalities had lower ACSC hospitalization rates. Increased PHC coverage and lower socioeconomic inequality were also associated with the reduction in hospitalizations. CONCLUSIONS The reduction in ACSC hospitalization rates over time was associated with an increase in the quality of PHC. It was also associated with a reduction in the number of hospital beds and municipalities with better socioeconomic indicators. |
| first_indexed | 2024-03-11T10:44:29Z |
| format | Article |
| id | doaj.art-e8176faf5540468a8497eaba594fd179 |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-03-11T10:44:29Z |
| publishDate | 2023-11-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-e8176faf5540468a8497eaba594fd1792023-11-14T07:45:11ZengUniversidade de São PauloRevista de Saúde Pública1518-87872023-11-015710.11606/s1518-8787.2023057004879Association between hospitalizations for sensitive conditions and quality of primary careFilipe Malta dos Santoshttps://orcid.org/0000-0002-0522-0374César Macieirahttps://orcid.org/0000-0002-3238-4489Antônio Thomaz Gonzaga da Matta Machadohttps://orcid.org/0000-0002-0516-8529Elis Mina Seraya Bordehttps://orcid.org/0000-0001-5560-6956Alzira de Oliveira Jorgehttps://orcid.org/0000-0003-1366-1732Bruno Abreu Gomeshttps://orcid.org/0000-0002-3664-4129Alaneir Fatima dos Santoshttps://orcid.org/0000-0002-7674-0449ABSTRACT OBJECTIVE To analyze the association between municipal rates of ambulatory care sensitive conditions (ACSC) hospitalization and the quality of primary health care (PHC), socioeconomic, and demographic variables and those related to local characteristics of the health system from 2010 to 2019. METHOD Ecological time series study in Brazilian municipalities analyzing the correlation of ACSC hospitalization rates with PHC quality measured by the three cycles of the Primary Care Access and Program for improving primary care access and quality (PMAQ-AB). The study included municipalities whose teams participated in 80% or more of at least two PMAQ-AB cycles. The correlation between standardized ACSC hospitalization rates and PHC quality and other variables was analyzed. Spearman’s test was used between the response variable and numerical explanatory variables. Generalized equations estimation was used as a multivariate model associating ACSC hospitalization rates with the other variables over the years. RESULTS A total of 3,500 municipalities were included in the models. The quality of PHC (PMAQ-AB score) showed an inverse association with the variation in ACSC hospitalization rates. Hospitalization rates fell by -2% per year every ten-point increase in the PMAQ-AB score, adjusted by the remaining variables. A one-unit increase in the beds per 1,000 inhabitants variable had an impact of approximately +6.4% on ACSC hospitalization rates. Regarding population size, larger municipalities had lower ACSC hospitalization rates. Increased PHC coverage and lower socioeconomic inequality were also associated with the reduction in hospitalizations. CONCLUSIONS The reduction in ACSC hospitalization rates over time was associated with an increase in the quality of PHC. It was also associated with a reduction in the number of hospital beds and municipalities with better socioeconomic indicators.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102023000100271&tlng=ptPrimary Health CareQuality of Health CareFamily Health |
| spellingShingle | Filipe Malta dos Santos César Macieira Antônio Thomaz Gonzaga da Matta Machado Elis Mina Seraya Borde Alzira de Oliveira Jorge Bruno Abreu Gomes Alaneir Fatima dos Santos Association between hospitalizations for sensitive conditions and quality of primary care Revista de Saúde Pública Primary Health Care Quality of Health Care Family Health |
| title | Association between hospitalizations for sensitive conditions and quality of primary care |
| title_full | Association between hospitalizations for sensitive conditions and quality of primary care |
| title_fullStr | Association between hospitalizations for sensitive conditions and quality of primary care |
| title_full_unstemmed | Association between hospitalizations for sensitive conditions and quality of primary care |
| title_short | Association between hospitalizations for sensitive conditions and quality of primary care |
| title_sort | association between hospitalizations for sensitive conditions and quality of primary care |
| topic | Primary Health Care Quality of Health Care Family Health |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102023000100271&tlng=pt |
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