Internações por condições sensíveis à atenção primária no Estado do Espírito Santo

• Autor(a) principal: Pazó, Rosalva Grobério
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Espírito Santo (riUfes)
• Texto Completo: http://repositorio.ufes.br/handle/10/5507
• topic: Primary health care; Quality indicators; Health care; Ambulatory care sensitive conditions; Ecological study; Atenção primária à saúde; Condições sensíveis à atenção primária; Estudo ecológico; Cuidados primários de saúde - Espírito Santo (Estado); Indicadores de qualidade em assistência à saúde; Saúde Coletiva; 614

Hospitalization for ambulatory care sensitive conditions (ACSC) are an outcome indicator used to assess the effectiveness and accessibility of health care provided by primary health care (PHC). The study aimed to investigate the ACSC in Espírito Santo in 2010 and its relationship to collective determinants. This ecological study used data of admissions occurred in 2010, collected from Public Health System of Brazil (SUS). The study variables were: ACSC, city size, demographic, socioeconomic and health service resources. Models were adjusted for the total population and age group. In statistical analysis was performed bivariate and multivariable Poisson regression with robust variance. The explanatory variables were ordered according to hierarchical approach of ACSC, in which socioeconomic characteristics, geographic and demographic set the distal model, the organization of health services corresponded to the intermediate model and performance indicators of health services came as a proximal model. The results showed that the majority of municipalities in the state is small (53,8%) and in them were found the highest coverage of the Family Health Strategy (FHS) and Community Agents Program (PACS) (99,9 %). The larger municipalities have the best results among the socioeconomic variables and greater coverage of health insurance (46%). In the final multivariate analysis, both in the general population as to age group, there was a positive association with the risk of ACSC: a) the percentage of illiteracy that has reached the highest value in pediatric patients, relative risk (RR) 1.17, b) the proportion of SUS beds representing an increase of 1.12 times the risk in the general population, and c) urbanization (RR: 1.02 to 1.03). Were associated with lower risk of ICSAP: a) be black (RR: 0.97-0.98) in all extracts studied, and b) increased coverage of health insurance (RR: 0.97 to 0.98), in the general population, in adults and the elderly. In the final model there was no association of FHS and PACS coverage with ACSC. It was concluded that there are ACSC determinants of which are outside the scope of PHC and may be implicated in the pattern of use of services, such as socioeconomic, demographic profile and the ease of access to health services in secondary and tertiary care, as well as the private network.