Internações por condições sensíveis à atenção primária no estado de São Paulo

Abstract

Internments suitable for Primary Healthcare constitute a new indicator used in some countries to indirectly measure the resolution capability of Primary Healthcare. The scope of this study is to present the panorama of the internments suitable for primary healthcare in Sao Paulo State. An ecological descriptive study was carried out for the period from 2000 to 2007. The data were generated by patient's county of residence and grouped by Regional Health Departments. The Information Systems of the Health Ministry and the population estimates of the Brazilian Institute of Geography and Statistics (IBGE) were used to obtain the data of all patients. The internments suitable for primary healthcare in the state follow a tendency toward reduction suggesting a connection with the adoption of the Family Health Program. A reduction in internments for diabetes was detected and attention was drawn to the increase of internment for illnesses related to prenatal care and childbirth. In light of the recent publication of the Brazilian Diagnostics List, studies that analyze the statistics from it can be very useful for managers involved with primary care, and can serve as benchmarks for quality and contribute to assessment for the implementation of health policies in Brazil.

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

“…No âmbito nacional, há relatos da diminuição das taxas de ICSAP associadas ao crescimento de cobertura da ESF 11,17 . Ao contrário disso, no presente estudo, a cobertura da atenção primária à saúde, representada pela cobertura da ESF e do PACS, apresentou, na análise bivariada, uma discreta associação positiva com as internações sensíveis, ou seja, quanto maior a cobertura maior o número dessas hospitalizações.…”

Internações por condições sensíveis à atenção primária no hospital geral de uma microrregião de saúde do município de São Paulo, Brasil

“…The reduction in the HACSCs, as shown in the above data, converges with results from other studies that indicate a reduction or stabilization of HACSCs in Brazil. 8,[12][13][14] An important aspect to be considered concerns the exclusion of the hospitalizations for childbirth, in order to provide a clearer analysis of the HACSCs. Childbirth is not a disease and, if retained, would mask the data by reducing the proportionate share of the real diseases (when excluding the births, the proportion of HACSC in the PGH increased from 21.02% to 26.1%).…”

“…8,14 Concerning the diseases preventable by immunization and sensitive conditions, attention is drawn to the reduction of these hospitalizations in the PGH, converging with results of other studies. 8,[12][13] Conversely, it was observed that hospitalization due to causes related to childbirth and the prenatal period, the only group that increased the occurrence during the study period (36.8%), continued to take place in the PGH, as in other areas of Brazil. This fact stands out, considering that the monitoring of pregnant women in the actions related to the prenatal period and childbirth is one of the priorities of primary healthcare.…”

“…Dependence on the hospital information and problems in the records of the HAs/HIS are some issues that should be considered when using this indicator. The results of the HACSCs, in studies conducted in Brazil, 8,[12][13][14] which feature gastroenteritis and its complications, iron deficiency anemia, arterial hypertension, and diabetes, among others, indicate the coexistence of a double burden of disease, which can be defined as diseases of poverty and development. In this sense, the hospitalizations for gastroenteritis and its complications, for example, may not necessarily occur due to lack of access and effectiveness of the primary healthcare, but as a result of the process of social production and reproduction, which, in turn, defines the processes of sickness and dying of the social groups.…”

Núcleos de Apoio à Saúde da Família: impactos nas internações por causas sensíveis à atenção básica

“…In this way, it is expected that an effective PC may reduce ACSC, including readmission of patients and stay time at the hospital [8][9][10] . When the PC does not guarantee sufficient and appropriate access, there is an excessive demand for medium and high complexity levels, with costs and unnecessary displacement [11][12][13] .…”