Abstract
ABSTRACT Objective: describe hospitalizations for ambulatory care sensitive chronic conditions in the state of Paraná, Brazil from 2000 to 2011 Method: epidemiological ecological study was to. After descriptive analysis of the data, hospitalization indicators were developed to describe the results. Results: this study’s findings suggest that efforts to implement and expand Primary Health Care in Paraná in the last decade resulted in a decrease in the proportion of hospitalizations for ambulatory care sensitive conditions and the average number of hospitalizations for noncommunicable chronic diseases, though the ratio of hospitalizations to resident population has increased. Conclusion: attention should be specifically paid to certain causes of hospitalization, such as hypertension and diabetes mellitus, to further minimize hospitalizations for Cerebrovascular Diseases and Congestive Heart Failure, which remained high.
Highlights
Ambulatory care sensitive conditions (ACSC) represent a group of health problems for which the effective action of primary care health can decrease the risk of hospitalization.[1,2] These conditions are listed per groups of causes for hospitalizations and diagnoses according to the International Classification of Diseases – 10th Revision (ICD-10)
When the frequency of hospitalizations was analyzed according to sex, we verified that hospitalizations caused by most diseases were more frequent among women than among men (AH: 60.88% vs. 39.12%; diabetes mellitus (DM): 61.88% vs. 38.12%; congestive heart failure (CHF): 52.90% vs. 47.10%)
When the average number (Table 1) of hospitalizations for chronic diseases was calculated according to three-year periods and sex, a decrease in the average number of hospitalizations caused by arterial hypertension (AH) and CHF was observed for both sexes [(AH - women: 796.77(SD=855.06) between 2000 and 2002 vs. 567.81(SD=357.64) between 2009 and 2011; men: 463.36 (SD=447.67) in 2000-2002 and 373.54 (SD=237.68) in 20092011); (CHF- women: 2,576.63 (SD=2,119.48) in 2000-2002 vs. 1,710.27 (SD=1,350.09) in 20092011; men: 2,261.5(SD=1,853.46) in 2000-2002 vs. 1,533.68(SD=1,164.01) in 2009-2011)], though women still presented the highest average in the entire period under study
Summary
Ambulatory care sensitive conditions (ACSC) represent a group of health problems for which the effective action of primary care health can decrease the risk of hospitalization.[1,2] These conditions are listed per groups of causes for hospitalizations and diagnoses according to the International Classification of Diseases – 10th Revision (ICD-10). This list is used as an instrument to assess primary health care (PHC) or the use of hospital care.[3]. NCD were in the causal structure of most deaths and cases of impairment in Brazil, exceeding mortality caused by infectious and parasitic diseases, accounting for a large portion of expenses from hospital care provided by the Brazilian public health system (SUS) and in the private sector.[6]
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