Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon

Detalhes bibliográficos
Autor(a) principal: CARNEIRO, Vânia Cristina Campelo Barroso
Data de Publicação: 2021
Outros Autores: OLIVEIRA, Paulo de Tarso Ribeiro de, CARNEIRO, Saul Rassy, MACIEL, Marinalva Cardoso, PEDROSO, Janari da Silva, https://orcid.org/0000-0001-7277-4652, https://orcid.org/0000-0002-1969-380X, https://orcid.org/0000-0002-6825-0239, https://orcid.org/0000-0002-8670-8215, http://orcid.org/0000-0001-7602-834X
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFPA
Texto Completo: https://repositorio.ufpa.br/jspui/handle/2011/16045
Resumo: Background The Family Health Strategy (FHS) became consolidated as a primary care model and gate keeper for the Unified Health System (Sistema U´ nico de Sau´de, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expan sion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities. Methods In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the associ ation between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Para´, in the Brazilian Amazon, from 2008 to 2017. Results The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory. Conclusions The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.
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spelling 2023-11-01T12:31:07Z2023-11-01T12:31:07Z2021-04CARNEIRO, Vaˆnia Cristina Campelo Barroso et al. Evidence of the effect of primary care expansion on hospitalizations: panel analysis of 143 municipalities in the Brazilian Amazon. PLoS ONE, online, v. 16, n. 4, e0248823, 2021. DOI: https://doi.org/10.1371/journal.pone.0248823. Disponível em: https://repositorio.ufpa.br/jspui/handle/2011/16045. Acesso em:.1932-6203https://repositorio.ufpa.br/jspui/handle/2011/1604510.1371/journal.pone.0248823Background The Family Health Strategy (FHS) became consolidated as a primary care model and gate keeper for the Unified Health System (Sistema U´ nico de Sau´de, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expan sion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities. Methods In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the associ ation between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Para´, in the Brazilian Amazon, from 2008 to 2017. Results The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory. Conclusions The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoUFPA - Universidade Federal do ParáengPublic Library of SciencePLOSEstados unidosPLoS ONEhttp://creativecommons.org/licenses/by-nc-nd/3.0/br/info:eu-repo/semantics/openAccesshttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248823reponame:Repositório Institucional da UFPAinstname:Universidade Federal do Pará (UFPA)instacron:UFPAFamily Health Strategy (FHS)Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazoninfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article164e0248823http://lattes.cnpq.br/6016827909320274http://lattes.cnpq.br/9266787581530443http://lattes.cnpq.br/9162153771863939http://lattes.cnpq.br/7097094334421162http://lattes.cnpq.br/4096274367867186CARNEIRO, Vânia Cristina Campelo BarrosoOLIVEIRA, Paulo de Tarso Ribeiro deCARNEIRO, Saul RassyMACIEL, Marinalva CardosoPEDROSO, Janari da Silvahttps://orcid.org/0000-0001-7277-4652https://orcid.org/0000-0002-1969-380Xhttps://orcid.org/0000-0002-6825-0239https://orcid.org/0000-0002-8670-8215http://orcid.org/0000-0001-7602-834XORIGINALArticle_EvidenceEffectPrimary.pdfArticle_EvidenceEffectPrimary.pdfapplication/pdf1691088https://repositorio.ufpa.br/oai/bitstream/2011/16045/1/Article_EvidenceEffectPrimary.pdf506be7a8de13b5d66a4edfb880bbe4e1MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufpa.br/oai/bitstream/2011/16045/2/license_rdfe39d27027a6cc9cb039ad269a5db8e34MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81890https://repositorio.ufpa.br/oai/bitstream/2011/16045/3/license.txt2b55adef5313c442051bad36d3312b2bMD532011/160452023-11-01 09:36:08.084oai:repositorio.ufpa.br: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ório InstitucionalPUBhttp://repositorio.ufpa.br/oai/requestriufpabc@ufpa.bropendoar:21232023-11-01T12:36:08Repositório Institucional da UFPA - Universidade Federal do Pará (UFPA)false
dc.title.en.fl_str_mv Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
spellingShingle Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
CARNEIRO, Vânia Cristina Campelo Barroso
Family Health Strategy (FHS)
title_short Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_full Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_fullStr Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_full_unstemmed Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
title_sort Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon
author CARNEIRO, Vânia Cristina Campelo Barroso
author_facet CARNEIRO, Vânia Cristina Campelo Barroso
OLIVEIRA, Paulo de Tarso Ribeiro de
CARNEIRO, Saul Rassy
MACIEL, Marinalva Cardoso
PEDROSO, Janari da Silva
https://orcid.org/0000-0001-7277-4652
https://orcid.org/0000-0002-1969-380X
https://orcid.org/0000-0002-6825-0239
https://orcid.org/0000-0002-8670-8215
http://orcid.org/0000-0001-7602-834X
author_role author
author2 OLIVEIRA, Paulo de Tarso Ribeiro de
CARNEIRO, Saul Rassy
MACIEL, Marinalva Cardoso
PEDROSO, Janari da Silva
https://orcid.org/0000-0001-7277-4652
https://orcid.org/0000-0002-1969-380X
https://orcid.org/0000-0002-6825-0239
https://orcid.org/0000-0002-8670-8215
http://orcid.org/0000-0001-7602-834X
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/6016827909320274
http://lattes.cnpq.br/9266787581530443
http://lattes.cnpq.br/9162153771863939
http://lattes.cnpq.br/7097094334421162
http://lattes.cnpq.br/4096274367867186
dc.contributor.author.fl_str_mv CARNEIRO, Vânia Cristina Campelo Barroso
OLIVEIRA, Paulo de Tarso Ribeiro de
CARNEIRO, Saul Rassy
MACIEL, Marinalva Cardoso
PEDROSO, Janari da Silva
https://orcid.org/0000-0001-7277-4652
https://orcid.org/0000-0002-1969-380X
https://orcid.org/0000-0002-6825-0239
https://orcid.org/0000-0002-8670-8215
http://orcid.org/0000-0001-7602-834X
dc.subject.eng.fl_str_mv Family Health Strategy (FHS)
topic Family Health Strategy (FHS)
description Background The Family Health Strategy (FHS) became consolidated as a primary care model and gate keeper for the Unified Health System (Sistema U´ nico de Sau´de, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expan sion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities. Methods In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the associ ation between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Para´, in the Brazilian Amazon, from 2008 to 2017. Results The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory. Conclusions The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.
publishDate 2021
dc.date.issued.fl_str_mv 2021-04
dc.date.accessioned.fl_str_mv 2023-11-01T12:31:07Z
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dc.identifier.citation.fl_str_mv CARNEIRO, Vaˆnia Cristina Campelo Barroso et al. Evidence of the effect of primary care expansion on hospitalizations: panel analysis of 143 municipalities in the Brazilian Amazon. PLoS ONE, online, v. 16, n. 4, e0248823, 2021. DOI: https://doi.org/10.1371/journal.pone.0248823. Disponível em: https://repositorio.ufpa.br/jspui/handle/2011/16045. Acesso em:.
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dc.identifier.issn.pt_BR.fl_str_mv 1932-6203
dc.identifier.doi.pt_BR.fl_str_mv 10.1371/journal.pone.0248823
identifier_str_mv CARNEIRO, Vaˆnia Cristina Campelo Barroso et al. Evidence of the effect of primary care expansion on hospitalizations: panel analysis of 143 municipalities in the Brazilian Amazon. PLoS ONE, online, v. 16, n. 4, e0248823, 2021. DOI: https://doi.org/10.1371/journal.pone.0248823. Disponível em: https://repositorio.ufpa.br/jspui/handle/2011/16045. Acesso em:.
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