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- Title
Fatores associados às internações infantis por condições sensíveis à atenção primária no Brasil: estudo ecológico.
- Authors
Araujo dos Santos, Danilo Marcelo; Coelho Alves, Cláudia Maria; Hernandes Rocha, Thiago Augusto; da Silva, Núbia Cristina; de Sousa Queiroz, Rejane Christine; Oliveira Pinho, Judith Rafaelle; da Silva Lopes, Clarissa Galvão; Abreu Fonseca Thomaz, Erika Barbara
- Abstract
Objective. To investigate whether structural aspects of primary care units (PCUs) and the work processes of primary care teams are associated with the rate of hospitalizations for primary care-sensitive conditions (HPCSC) in children younger than 5 years of age in Brazil. Method. For this longitudinal ecological study, secondary data were obtained from the Brazilian Hospital Information System and from three cycles of the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB) (2012, 2014, 2017/2018). The analysis included 42 916 PCUs. A multilevel random intercept model with fixed slope was used. In the first level, the outcome (HPCSC rates) and explanatory variables (structure and process indicators) aggregated by PCU were analyzed. Social determinants (represented by a stratification criterion combining municipality population and health care management indicators) were entered in the second level. The t test with Bonferroni correction was used to compare indicator means between regions, and multilevel linear regression was used to estimate the correlation coefficients. Results. The HPCSC rate in children younger than 5 years was 62.78/100 thousand population per estimated PCU coverage area. A direct association with the outcome was observed for: participation in one or more PMAQ-AB cycles; team planning; special hours; dedicated pediatric care area; and availability of vaccines. Equipment, materials, supplies, and being a small or medium-size municipality were inversely associated with HPCSC. Conclusions. HPCSC rates in children below 5 years of age may potentially be reduced through improvements in PCU structure and process indicators and in municipal social determinants.
- Subjects
BRAZIL; HOSPITALS; PRIMARY care; BONFERRONI correction; MEDICAL care; HEALTH status indicators
- Publication
Pan American Journal of Public Health, 2022, Vol 46, p1
- ISSN
1020-4989
- Publication type
Article
- DOI
10.26633/RPSP.2022.63