Lívia Anniele Sousa Lisboa1, Rejane Christine de Sousa Queiroz2, Erika Bárbara Abreu Fonseca Thomaz1, Núbia Cristina da Silva3, Thiago Augusto Hernandes Rocha4, João Ricardo Nickenig Vissoci5, Catherine Ann Staton5, Adriana Lein5, Vanda Maria Ferreira Simões2, Elaine Thumé6, Luiz Augusto Facchini7. 1. Universidade Federal do Maranhão. Programa de Pos graduação em Saúde Pública. São Luís, Maranhão, Brasil. 2. Universidade Federal do Maranhão. Programa de Pos graduação em Saúde Pública. Departamento de Saúde Pública. São Luís, Maranhão, Brasil. 3. Universidade Federal de Minas Gerais. Observatório de Recursos Humanos em Saúde. Belo Horizonte, Minas Gerais, Brasil. 4. Organização Pan Americana de Saúde: OPAS/WHO - Brasília, Distrito Federal, Brasil. 5. Duke University. Duke Global Health Institute. Durham, North Carolina. U.S. 6. Universidade Federal de Pelotas. Programa de Pós-graduação em Enfermagem. Departmento de Enfermagem. Pelotas, Rio Grande do Sul, Brasil. 7. Universidade Federal de Pelotas. Programas de Pós-graduação em Epidemiologia e Enfermagem. Departmento de Medicina Social. Pelotas, Rio Grande do Sul, Brasil.
Abstract
OBJECTIVE: To evaluate the association among characteristics of primary health care center (PHCC) with hospitalizations for primary care sensitive conditions (PCSC) in Brazil. METHOD: In this study, a cross-sectional ecological study was performed. This study analyzed the 27 capitals of Brazil's federative units. Data were aggregated from the following open access databases: National Program for Access and Quality Improvement in Primary Care, the Hospital Information System of Brazilian Unified Health System and Annual Population Census conducted by the Brazilian Institute of Geography and Statistics. Associations were estimated among characteristics of primary care with the number of three PCSC as the leading causes of hospitalization in children under-5 population in Brazil: asthma, diarrhea, and pneumonia. RESULTS: In general, PHCC showed limited structural adequacy (37.3%) for pediatric care in Brazil. The capitals in South and Southeast regions had the best structure whereas the North and Northeast had the worst. Fewer PCSC hospitalizations were significantly associated with PHCC which presented appropriate equipment (RR: 0.98; 95%CI: 0.97-0.99), structural conditions (RR: 0.98; 95%CI: 0.97-0.99), and signage/identification of professionals and facilities (RR: 0.98; 95%CI: 0.97-0.99). Higher PCSC hospitalizations were significantly associated with PHCC with more physicians (RR: 1.23, 95%CI: 1.02-1.48), it forms (RR: 1.01, 95%CI: 1.01-1.02), and more medications (RR: 1.02, 95%CI: 1.01-1.03). CONCLUSION: Infrastructural adequacy of PHCC was associated with less PCSC hospitalizations, while availability medical professional and medications were associated with higher PCSC hospitalizations.
OBJECTIVE: To evaluate the association among characteristics of primary health care center (PHCC) with hospitalizations for primary care sensitive conditions (PCSC) in Brazil. METHOD: In this study, a cross-sectional ecological study was performed. This study analyzed the 27 capitals of Brazil's federative units. Data were aggregated from the following open access databases: National Program for Access and Quality Improvement in Primary Care, the Hospital Information System of Brazilian Unified Health System and Annual Population Census conducted by the Brazilian Institute of Geography and Statistics. Associations were estimated among characteristics of primary care with the number of three PCSC as the leading causes of hospitalization in children under-5 population in Brazil: asthma, diarrhea, and pneumonia. RESULTS: In general, PHCC showed limited structural adequacy (37.3%) for pediatric care in Brazil. The capitals in South and Southeast regions had the best structure whereas the North and Northeast had the worst. Fewer PCSC hospitalizations were significantly associated with PHCC which presented appropriate equipment (RR: 0.98; 95%CI: 0.97-0.99), structural conditions (RR: 0.98; 95%CI: 0.97-0.99), and signage/identification of professionals and facilities (RR: 0.98; 95%CI: 0.97-0.99). Higher PCSC hospitalizations were significantly associated with PHCC with more physicians (RR: 1.23, 95%CI: 1.02-1.48), it forms (RR: 1.01, 95%CI: 1.01-1.02), and more medications (RR: 1.02, 95%CI: 1.01-1.03). CONCLUSION: Infrastructural adequacy of PHCC was associated with less PCSC hospitalizations, while availability medical professional and medications were associated with higher PCSC hospitalizations.