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因门诊护理敏感型疾病导致的老年人住院情况。

Hospitalization of older adults due to ambulatory care sensitive conditions.

作者信息

Marques Aline Pinto, Montilla Dalia Elena Romero, Almeida Wanessa da Silva de, Andrade Carla Lourenço Tavares de

出版信息

Rev Saude Publica. 2014 Oct;48(5):817-26. doi: 10.1590/s0034-8910.2014048005133.

Abstract

OBJECTIVE

To analyze the temporal evolution of the hospitalization of older adults due to ambulatory care sensitive conditions according to their structure, magnitude and causes.

METHODS

Cross-sectional study based on data from the Hospital Information System of the Brazilian Unified Health System and from the Primary Care Information System, referring to people aged 60 to 74 years living in the state of Rio de Janeiro, Souhteastern Brazil. The proportion and rate of hospitalizations due to ambulatory care sensitive conditions were calculated, both the global rate and, according to diagnoses, the most prevalent ones. The coverage of the Family Health Strategy and the number of medical consultations attended by older adults in primary care were estimated. To analyze the indicators' impact on hospitalizations, a linear correlation test was used.

RESULTS

We found an intense reduction in hospitalizations due to ambulatory care sensitive conditions for all causes and age groups. Heart failure, cerebrovascular diseases and chronic obstructive pulmonary diseases concentrated 50.0% of the hospitalizations. Adults older than 69 years had a higher risk of hospitalization due to one of these causes. We observed a higher risk of hospitalization among men. A negative correlation was found between the hospitalizations and the indicators of access to primary care.

CONCLUSIONS

Primary healthcare in the state of Rio de Janeiro has been significantly impacting the hospital morbidity of the older population. Studies of hospitalizations due to ambulatory care sensitive conditions can aid the identification of the main causes that are sensitive to the intervention of the health services, in order to indicate which actions are more effective to reduce hospitalizations and to increase the population's quality of life.

摘要

目的

根据老年患者因门诊可防性疾病住院的结构、规模和原因,分析其时间演变情况。

方法

基于巴西统一卫生系统医院信息系统和初级保健信息系统的数据进行横断面研究,研究对象为居住在巴西东南部里约热内卢州的60至74岁人群。计算因门诊可防性疾病住院的比例和发生率,包括总体发生率以及根据诊断得出的最常见疾病的发生率。估算家庭健康战略的覆盖范围以及老年人在初级保健中接受医疗咨询的次数。为分析这些指标对住院情况的影响,采用线性相关检验。

结果

我们发现,所有病因和年龄组因门诊可防性疾病住院的情况都大幅减少。心力衰竭、脑血管疾病和慢性阻塞性肺疾病占住院病例的50.0%。69岁以上成年人因这些病因之一住院的风险更高。我们观察到男性住院风险更高。住院情况与初级保健可及性指标之间存在负相关。

结论

里约热内卢州的初级医疗保健对老年人群的医院发病率产生了重大影响。对因门诊可防性疾病住院情况的研究有助于确定对卫生服务干预敏感的主要病因,从而指明哪些行动在减少住院和提高人群生活质量方面更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0b5/4211570/a3168f198216/0034-8910-rsp-48-5-0817-gf01.jpg

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