Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil

Detalhes bibliográficos
Autor(a) principal: Hone, Thomas
Data de Publicação: 2022
Outros Autores: Macinko, James, Trajman, Anete, Palladino, Raffaele, Coeli, Claudia Medina, Saraceni, Valeria, Rasella, Davide, Durovni, Betina, Millett, Christopher
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/153983
Resumo: Funding Information: This study was supported by the UK's Joint Health Systems Research Initiative (DFID/MRC/Wellcome Trust/ESRC) grant number MR/P014593/1. This funder had no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication. Publisher Copyright: © 2022 The Author(s)
id RCAP_b05cf850936c2d82fc59d9b75186ae8b
oai_identifier_str oai:run.unl.pt:10362/153983
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazila cohort analysisAdmissionsBrazilHospitalisationsPrimary careHealth PolicyInternal MedicinePublic Health, Environmental and Occupational HealthSDG 3 - Good Health and Well-beingFunding Information: This study was supported by the UK's Joint Health Systems Research Initiative (DFID/MRC/Wellcome Trust/ESRC) grant number MR/P014593/1. This funder had no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication. Publisher Copyright: © 2022 The Author(s)Background: Robust evidence on the relationship between primary care and emergency admissions is lacking in low- and middle-income countries. This study evaluates how the phased roll out of the family health strategy (FHS) to the urban poor in Rio de Janeiro Brazil affected emergency hospital admissions and readmissions from ambulatory-care sensitives conditions (ACSCs). Methods: A cohort of 1.2 million adults in Rio de Janeiro city were followed for five years (Jan 2012 to Dec 2016). The association between FHS use and the likelihood of emergency hospital admissions and 30-day readmissions were evaluated using multi-level Poisson regression models with inverse probability treatment weighting and regression adjustment (IPTW-RA) for socioeconomic and household characteristics. Inequalities in associations were examined across groups of causes and by key socioeconomic groups. Results: Records from 2,551,934 primary care consultations and 15,627 admissions were analysed. In IPTW-RA analyses, each additional FHS consultation was associated with a 3% lower rate of ACSC admission (RR: 0.97; 95%CI: 0.95, 0.98), a 63% lower rate of 30-day readmissions from any non-birth cause (RR: 0.37; 95%CI: 0.30, 0.46), and an 57% lower rate of 30-day readmissions from ACSCs (RR: 0.43; 95%CI: 0.33, 0.55). Individuals who were older, had the lowest educational attainment, were unemployed, and had higher incomes had larger reductions in ACSC admissions associated with FHS use. Interpretation: Investment in primary care is important for reducing emergency hospital admissions and their associated costs in LMICs. Funding: DFID/MRC/Wellcome Trust/ESRC.Centro de Investigação em Saúde Pública (CISP/PHRC)Comprehensive Health Research Centre (CHRC) - Pólo ENSPEscola Nacional de Saúde Pública (ENSP)RUNHone, ThomasMacinko, JamesTrajman, AnetePalladino, RaffaeleCoeli, Claudia MedinaSaraceni, ValeriaRasella, DavideDurovni, BetinaMillett, Christopher2023-06-15T22:20:56Z2022-112022-11-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/153983eng2667-193XPURE: 63756700https://doi.org/10.1016/j.lana.2022.100363info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:36:26Zoai:run.unl.pt:10362/153983Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:55:27.058762Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
a cohort analysis
title Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
spellingShingle Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
Hone, Thomas
Admissions
Brazil
Hospitalisations
Primary care
Health Policy
Internal Medicine
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
title_short Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
title_full Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
title_fullStr Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
title_full_unstemmed Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
title_sort Expansion of primary healthcare and emergency hospital admissions among the urban poor in Rio de Janeiro Brazil
author Hone, Thomas
author_facet Hone, Thomas
Macinko, James
Trajman, Anete
Palladino, Raffaele
Coeli, Claudia Medina
Saraceni, Valeria
Rasella, Davide
Durovni, Betina
Millett, Christopher
author_role author
author2 Macinko, James
Trajman, Anete
Palladino, Raffaele
Coeli, Claudia Medina
Saraceni, Valeria
Rasella, Davide
Durovni, Betina
Millett, Christopher
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Centro de Investigação em Saúde Pública (CISP/PHRC)
Comprehensive Health Research Centre (CHRC) - Pólo ENSP
Escola Nacional de Saúde Pública (ENSP)
RUN
dc.contributor.author.fl_str_mv Hone, Thomas
Macinko, James
Trajman, Anete
Palladino, Raffaele
Coeli, Claudia Medina
Saraceni, Valeria
Rasella, Davide
Durovni, Betina
Millett, Christopher
dc.subject.por.fl_str_mv Admissions
Brazil
Hospitalisations
Primary care
Health Policy
Internal Medicine
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
topic Admissions
Brazil
Hospitalisations
Primary care
Health Policy
Internal Medicine
Public Health, Environmental and Occupational Health
SDG 3 - Good Health and Well-being
description Funding Information: This study was supported by the UK's Joint Health Systems Research Initiative (DFID/MRC/Wellcome Trust/ESRC) grant number MR/P014593/1. This funder had no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the paper for publication. Publisher Copyright: © 2022 The Author(s)
publishDate 2022
dc.date.none.fl_str_mv 2022-11
2022-11-01T00:00:00Z
2023-06-15T22:20:56Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/153983
url http://hdl.handle.net/10362/153983
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2667-193X
PURE: 63756700
https://doi.org/10.1016/j.lana.2022.100363
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799138141528915968

Registros relacionados