Social determinants of hospitalizations for ambulatory care sensitive conditions in Guarulhos, São Paulo

Abstract

The study goals present an overview of Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) in Guarulhos, SP, from 2008 to 2012. This is an ecological study based on secondary data obtained from the Brazilian Hospital Information System, and supported by the Praxical Theory of Intervention of Collective Health Nursing. Applied descriptive statistics for analysis. It was observed that Guarulhos shows an upward trend in hospitalizations by ACSC (20% increase), the most frequent causes of heart failure (11.8%), cerebrovascular disease (10.6%) and angina (9.7%), most frequently in the age group ≥ 65years old, for both sexes. The results are similar to other Brazilian studies, but their analysis should extrapolate the biological limits and the supply of healthcare resources, focusing on the social determinants of the health-disease process.

Desigualdades intraurbanas de taxas de internações por condições sensíveis à atenção primária na região central do Brasil

“…Similar results were found by Burgdof & Sunddmacher 6 and Pazo et al 46 , who reported a positive association between number of beds and rates of admissions for ACSCs. This finding contradicts several studies that found an association between increased primary health care coverage and reduced rates of admissions for ACSCs 29,31,[47][48][49] . The most common group of causes among the 40 to 59 years age group was chronic disease, comprised of angina and heart failure, diabetes mellitus and hypertension.…”

“…Studies conducted both inside and outside Brazil have shown that epidemiological indicators built upon ACSCs data, such as the rates of admission examined in this article, provide a quick and simple way of monitoring and evaluating access to and the effectiveness of primary health care services provided by universal public health systems such as the SUS [24][25][26][27][28][29] . Despite their usefulness, other studies have suggested that the use of ACSCs as indicators is limited due to the following reasons: (i) they do not consider the severity of a patient's medical condition and the fragility of the individual; (ii) they do not consider specific patient characteristics and differences in admission criteria between different hospital services; (iii) they do not directly consider the socioeconomic profile of a given population, level of education and cultural characteristics 1,3,[30][31][32][33][34] . Our findings show that the average rate of admissions for ACSCs in Goiânia in the period 2008 to 2013 was 152.7 per 10,000 population and that rates were highest among the zero to nine years and 60 years and over age groups.…”

Factors associated with the care of elderly persons with Primary Health Care sensitive conditions

“…In the municipal region where the study was carried out, the data also showed an increase in the number of registered teams, with 75 currently in operation, providing population coverage of 68.01% 15,18 . Despite this progress, there are still complex challenges in PHC to be overcome, such as using the information that is collected and provided by the FHS teams themselves.…”

“…At the beginning of 2016 this number had grown to 48,410 teams, with a population coverage of approximately 64%. In the state of Paraná, the numbers show an even more significant increase, with the number of teams increasing from 115 in 1998 to 2,868 in 2016, covering 68% of the population of the state 18 .…”

Profile of hospitalizations and prevalence of conditions sensitive to primary care in a university hospital

“…In order to the evaluate health services, particularly the Primary Health Care, and aiming to subsidize more effective and robust public policies, the Ministry of Health adopted the List of Conditions Sensitive to Primary Care after adjusting it to the national reality (3) , becoming an important tool in the context of scientific production and management of health services in Brazil. Although research shows that the presence of primary health care contributes to reduce the risk of hospitalizations due to conditions sensitive to primary care (4)(5) , it is notable that this phenomenon does not occur in a linear manner throughout the national territory (6)(7) .…”