Integrated health service delivery networks and tuberculosis avoidable hospitalizations: is there a relation between them in Brazil?

Marcela Paschoal Popolin,Antônio Carlos Vieira Ramos,Marcelino Santos Neto,Thais Zamboni Berra,Luís Velez Lapão,Ione Carvalho Pinto,Francisco Chiaravalotti Neto,Mellina Yamamura,Inês Fronteira,Ludmila Barbosa Bandeira Rodrigues,Maria Concebida Da Cunha Garcia,Ricardo Alexandre Arcêncio,Luiz Henrique Arroyo,Juliane De Almeida Crispim,Pedro Fredemir Palha,Michelle Mosna Touso,Severina Alice Da Costa Uchoa

doi:10.1186/s12913-016-1320-y

Abstract

BackgroundThe early identification of the Breathing Symptoms within the scope of Primary Health Care is recommended, and is also one of the strategies of national sanitary authorities for reaching the elimination of tuberculosis. The purpose of this study is to consider which attributes and which territories have shown the most significant progress in Primary Health Care, in terms of coordination of Health Care Networks, and also check if those areas of Primary Health Care that are most critical regarding coordination, there were more or less cases of avoidable hospitalizations for tuberculosis.MethodsThis is an ecological study that uses primary and secondary data. For analysis, coropletic maps were developed through the ArcGIS software, version 10.2. There was also the calculation of gross annual and Bayesian rates for hospitalizations for tuberculosis, for each Primary Health Care territory.ResultsThere were satisfactory results for attributes such as Population (n = 37; 80.4 %), Primary Health Care (n = 43; 93.5 %), Support System (n = 45; 97.8 %); the exceptions were Logistics System (n = 32; 76.0 %) and Governance System, with fewer units in good condition (n = 31; 67.3 %). There is no evidence of any connection between networks’ coordination by Primary Health Care and tuberculosis avoidable admissions.ConclusionThe results show that progress has been made regarding the coordination of the Health Care Networks, and a positive trend has been shown, even though the levels are not excellent. It was found no relationship between the critical areas of Primary Health Care and tuberculosis avoidable hospitalizations, possibly because other variables necessary to comprehend the phenomena.

Highlights

The early identification of the Breathing Symptoms within the scope of Primary Health Care is recommended, and is one of the strategies of national sanitary authorities for reaching the elimination of tuberculosis
Considering that the configuration of a health system in an Health Care Networks (HCNs) is an essential condition for the truthfulness and ability to solve problems, of the health services, and for the control of TB in Brazil, and the fact that there are decisive or strategic characteristics for effective coordination by Primary Health Care (PHC), we propose to investigate the issue of where, and in which attributes, the PHC has made most progress in terms of coordination of the HCN in a large Brazilian municipality, and check to see whether there has been an increase in avoidable hospitalizations due to TB in the critical areas of PHC
The study showed the problem of avoidable hospitalizations for TB in an endemic city in Brazil, noting a random distribution of hospitalizations regardless of the quality of the PHV in the co-ordination of Health Care Networks (HCNs)

Summary

Introduction

The early identification of the Breathing Symptoms within the scope of Primary Health Care is recommended, and is one of the strategies of national sanitary authorities for reaching the elimination of tuberculosis. Recent studies have shown an increase in admittances to hospital with TB [3, 4]; a transversal cut study in the municipality of São Paulo, comparing the outcomes between patients hospitalized with those receiving outpatient treatment, showed a lower rate of cure and a higher rate of mortality among the patients who had been hospitalized [5] Another study, this one of an ecological type, performed in the state of São Paulo [6] showed a prevalence of hospitalizations among males, and the presence of a significant number of hospitalized children, and clearly shows that PHC has been quite feeble in promoting health, prevention of new cases, diagnosis and early treatment

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Conclusion