HOSPITAL ADMISSIONS FOR AMBULATORY CARE-SENSITIVE CONDITIONS IN SERGIPE - BRAZIL: AN ECOLOGICAL STUDY

Abstract

The rate of hospitalization for Ambulatory Care-Sensitive Conditions is an indicator of the effectiveness of this level of care in the health system. The objective of this study is to describe the behavior of Hospitalizations for Primary Health Care Sensitive Conditions in Sergipe, from 2008 to 2017. This is an ecological study, with a temporal trend. Data were extracted from the Hospital Admission Authorizations of the Hospital Information System of the Unified Health System. Standardized rates by indirect method and proportions of hospitalizations were analyzed. Two explanatory models were tested for trend analysis and negative binomial regression in view of the large overdispersion observed.  There were 608,083 non-obstetric hospitalizations, 125,497 cases of hospitalizations for Primary Care-Sensitive Conditions (20.6%), an overall crude rate of 5.6 admissions per thousand inhabitants (5.7 males and 5.8 females). The trend described a U-shaped curve, decreasing in the period from 2008 to 2011, with little oscillation from 2011 to 2014, ascending from 2014 to 2017. The rate was considerably higher in men over 70 years of age. Throughout the period, the most frequent causes were: gastroenteritis (15.6%), kidney and urinary tract infection (9.4%), asthma (9.2%), heart failure (8.8%), cerebrovascular (8.1%), diabetes mellitus (7.2%).  The improvement that had been observed in the effectiveness of primary care is discontinued and hospitalizations rise again, reaching the end of the period with values close to those of the beginning. Public policies that strengthened Primary Care may have contributed to the better performance of the indicator.