The role of primary care in preventing ambulatory care sensitive conditions

Abstract

A core list of ACSC as markers of PHC effectiveness identifies health conditions amenable to specific aspects of PHC and minimizes the limitations attributable to variations in hospital admission policies. An expanded list should be useful to evaluate global PHC performance and to analyse market responsibility for ACSC by PHC and Specialist Care.

Hospitalization due to conditions sensitive to primary care and expansion of the Family Health Program in Brazil: an ecological study

“…In this study, the declining number of hospitalizations for ACSC in brazil became clear, thus corroborating investigations conducted in other regions and countries, in which it was possible to observe the relationship between the reduced number of hospitalizations for ACSC and the increasing primary care 11,[19][20][21][23][24][25][26] . On the other hand, when health care is performed by services who do not work with the FHS, there is significant increase in hospitalization rates for ACSC 4 .…”

“…In 1999, there were 4,114 FHS teams distributed in 30% of the cities, comprehending 14 million people and 9% of the country's population 11 . In 2006, there were 26,364 FHS teams, reaching 49% of the population coverage.…”

“…Hospitalizations were selected from the Brazilian list of ACSC 16 , elaborated by the Ministry of Health in 2005 (Table 1), which identifies conditions that are sensitive to primary health care 11 . There are 20 groups of causes including pathologies and conditions belonging to each chapter of the ICD-10.…”

“…The ACSCs are morbidities that can be dealt with in primary care, thus preventing the aggravation of the clinical condition and unnecessary hospitalizations; besides, they constitute an indicator that measures the quality and the resoluteness of FHS [9][10][11][12] In Brazil, the hospitalization rate is of 525 per 10 thousand inhabitants, and 27% of them are caused by preventable conditions. Among the conditions that lead to hospitalization for ACSCs, pre-existing and transmissible diseases, heart and respiratory conditions, as well as diseases of the circulatory system and those related to prenatal and labor periods are prevalent 12 .…”

“…The reduced number of hospitalizations due to ACSC is one of the markers of the effectiveness of FHS 13,14 , based on the fact that hospitalized people were not adequately cared for in the primary level, thus leading to the aggravation of their clinical condition [10][11][12] .…”