Programa de Pós-Graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, RS, Brasil.
Rev Saude Publica. 2011 Aug;45(4):765-72. doi: 10.1590/s0034-89102011000400017.
To compare rates of hospitalization for primary care-sensitive conditions in the major municipalities of regional health districts.
An ecological study was carried out with both male and female subjects aged 20 to 59 years in the major municipalities of regional health districts in the state of Rio Grande do Sul, Southern Brazil, between 1995 and 2007. Hospitalization data were obtained from the database of the Brazilian Health Care System (Datasus). Rates by Poisson regression with robust variance were analyzed. Rates for each municipality were compared to those of the remainder of the Rio Grande do Sul state excluding the major municipalities of each district.
There was a reduction in the rates of hospitalization for primary care-sensitive conditions in all municipalities, with the exception of Porto Alegre (1.01) and Osório (1.02). Among larger municipalities, the greatest reductions were observed in Santa Maria (0.92) and Pelotas (0.93). Rates in medium-sized municipalities showed a decrease towards the end of the study period. Among small municipalities, only Lajeado and Frederico Westphalen showed rates lower than those of the rest of the state in 2007. The highest rates were found in the smallest municipalities.
There was a trend towards a reduction in hospitalizations in almost all municipalities, possibly due to the expansion of primary health care that took place even prior to the implementation of the Family Health Program and changes in management. The high rates of hospitalization in small municipalities suggest that hospitalization for primary care-sensitive conditions may be a means of justifying an idle supply of hospital beds.
比较区域卫生区主要城市初级保健敏感条件的住院率。
在巴西南里奥格兰德州，对年龄在 20 至 59 岁的男性和女性进行了一项生态研究，研究对象来自区域卫生区的主要城市，研究时间为 1995 年至 2007 年。住院数据来自巴西医疗保健系统数据库（Datasus）。采用泊松回归分析具有稳健方差的比率。将每个城市的比率与除每个区主要城市以外的南里奥格兰德州其他地区的比率进行比较。
除了阿雷格里港（1.01）和奥索里奥（1.02）外，所有城市的初级保健敏感条件住院率均有所下降。在较大的城市中，圣玛丽亚（0.92）和佩洛塔斯（0.93）的降幅最大。在中等规模的城市中，这一比率在研究期末呈下降趋势。在规模较小的城市中，只有拉热伊达和弗雷德里科·韦斯特法伦在 2007 年的比率低于该州其他地区。最高的比率出现在最小的城市。
几乎所有城市的住院率都呈下降趋势，这可能是由于初级保健的扩大，这种扩大甚至发生在家庭健康计划实施之前，并且管理方式也发生了变化。小型城市的高住院率表明，初级保健敏感条件的住院可能是一种为闲置的医院床位提供正当理由的手段。
