Hospital admissions due to ambulatory care sensitive conditions among children by age group and health region

Abstract

Objective: to describe hospital admissions for ambulatory care sensitive conditions in children under five years of age in the State of Paraná, Brazil by condition type, age group and health region. Method: a temporal ecological study was conducted using data from the Unified Health System Hospital Information System for the period 2000 to 2011. Conditions were grouped in accordance with the list of ambulatory care sensitive conditions in Brazil. Results: there was an increase in the rate of admissions for ambulatory care sensitive conditions in all age groups in 50% of the health regions, with a marked increase in children under the age of one. Pneumonia, gastroenteritis and asthma were the main causes of admissions. There was an increase in the proportion of overall admissions accounted for by pneumonia and gastroenteritis. Conclusion: the increase in admissions reveals the need for actions to improve access to primary healthcare and provide effective treatment of the main ambulatory care sensitive conditions in order to prevent hospital admissions among children.

Children's hospitalizations by sensitive conditions in primary care in the Northeast of Brazil

“…17 In this study, gastroenteritis were the most impacting conditions for hospitalizations of children under the age of five during the decade reported, corroborating results from other regions in the country, such as the South and the Southeast. 5,25 It is known that housing conditions, such as access to basic sanitation and running water are factors that influence the occurrence of these diseases. However, the performance of primary health services has an impact on its prevention, since part of the gastroenteritis is of mild intensity.…”

“…27 The respiratory system diseases were also important causes of hospitalization of children under the age of five in the Northeast region, which is in accordance to the reality of the country. 5,13,15,25 It was observed that among this group of diseases, asthma was the most frequent among children under five years old. Because it is a disease that combines genetic, environmental and other factors, the APS professionals must act, especially in the modifiable factors, through actions of promoting, preventing and controlling the affection.…”

Iniquidades étnico-raciais nas hospitalizações por causas evitáveis em menores de cinco anos no Brasil, 2009-2014

“…No entanto, estes autores alertam que deve haver cautela nas análises da evolução das ICSAP com vistas a discutir a efetividade da APS, pois tais indicadores sofrem efeitos dos contextos específicos, tanto relativos à organização dos serviços, quanto à cultura local. Os estudos publicados sobre ICSAP em crianças no Brasil não apresentam análises por cor/raça 3,4,5,36,40 , limitando comparações com os nossos achados.…”

“…As principais causas de internação foram doenças do aparelho respiratório (37,4%) e infecciosas e parasitárias (19,3%), sendo as crianças indígenas as mais acometidas. As taxas brutas de ICSAP (por 1.000) foram mais elevadas em indígenas (97,3; IC95%: 95, 2), seguidas das pardas (40,0;IC95%: 39,1), e as menores foram nas amarelas (14,8;IC95%: 14,(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)5). As maiores razões de taxas ajustadas de ICSAP foram registradas entre crianças de cor/raça indígena e branca - 5,7 (IC95%: 3,4) no país, atingindo 5,9 (IC95%: 5,0-7,1) e 18,5 (IC95%: 16,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]7) no Norte e Centro-oeste, respectivamente.…”

“…As internações por essas causas têm sido chamadas de internações por condições sensíveis à atenção primária (ICSAP) e utilizadas em diversos países como um indicador de efetividade da atenção primária à saúde (APS) 2 . Portanto, taxas de ICSAP elevadas em um segmento populacional sugerem limitações na cobertura e/ou na resolubilidade dos problemas de saúde na APS, evidenciando uma situação de vulnerabilidade social 3,4,5 . Cada país ou região, incluindo o Brasil, busca organizar sua lista de ICSAP com base nos padrões de saúde e organização da atenção à saúde, e nos recursos e possibilidades de intervenção disponíveis 2 .…”