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因基层医疗敏感疾病导致的住院情况:一项生态学研究。

Hospitalizations due to primary care sensitive conditions: an ecological study.

作者信息

Maia Ludmila Grego, Silva Luiz Almeida da, Guimarães Rafael Alves, Pelazza Bruno Bordin, Pereira Ana Cláudia Souza, Rezende Wender Lopes, Barbosa Maria Alves

机构信息

Universidade Federal de Goiás. Regional Jataí. Jataí, GO, Brasil.

Universidade Federal de Goiás. Regional Catalão. Catalão, GO, Brasil.

出版信息

Rev Saude Publica. 2018 Dec 20;53:02. doi: 10.11606/S1518-8787.2019053000403.

Abstract

OBJECTIVE

To evaluate the trend of hospitalizations due to primary care sensitive conditions and its relationship with the Family Health Strategy coverage.

METHODS

Ecological study of time series using the records from the Hospital Information System, from 2005 to 2015, with data for the state of Goiás, Brazil. Trend analyses were performed by the generalized linear regression method of Prais-Winsten with robust variance, which allowed to verify if the trend of hospitalizations due to primary care sensitive conditions was stationary (p > 0.05), declining (p < 0.05 and negative regression coefficient), or ascending (p < 0.05 and positive regression coefficient) in each region of Goiás and for each diagnosis group, stratified by sex. Pearson correlation was used to verify the degree of association between the Family Health Strategy coverage and the rate of hospitalizations due to primary care sensitive conditions.

RESULTS

Hospitalizations due to primary care sensitive conditions accounted for 1,092,070 (30.0%) of hospitalizations in Goiás. The average hospitalizations rate due to primary care sensitive conditions was statically less than the rate for other conditions in the analyzed period (167.6% against 386.2%; t = -13.18; p < 0.001). There has been a downward trend in hospitalizations trend due to primary care sensitive conditions in Goiás and in most health regions. The trends varied between sexes in the groups of causes. We observed a negative correlation between the Family Health Strategy coverage and the hospitalizations trend due to primary care sensitive conditions in the state and also in most health regions.

CONCLUSIONS

Hospitalizations due to primary care sensitive conditions had a significant reduction trend over the analyzed period. Despite this progressive decrease, this rate remains high and the reduction trend was not linear for all causes. These results allow for directing public policies, while drawing a general overview of hospitalizations due to primary care sensitive conditions by sex and region in the state.

摘要

目的

评估因基层医疗敏感疾病导致的住院趋势及其与家庭健康战略覆盖范围的关系。

方法

采用时间序列生态研究,利用2005年至2015年巴西戈亚斯州医院信息系统的记录。通过具有稳健方差的普雷斯-温斯坦广义线性回归方法进行趋势分析,以验证戈亚斯州各地区以及按性别分层的每个诊断组中,因基层医疗敏感疾病导致的住院趋势是否平稳(p>0.05)、下降(p<0.05且回归系数为负)或上升(p<0.05且回归系数为正)。使用皮尔逊相关性来验证家庭健康战略覆盖范围与因基层医疗敏感疾病导致的住院率之间的关联程度。

结果

在戈亚斯州,因基层医疗敏感疾病导致的住院病例占住院总数的1,092,070例(30.0%)。在分析期内,因基层医疗敏感疾病导致的平均住院率在统计学上低于其他疾病的住院率(分别为167.6%和386.2%;t=-13.18;p<0.001)。戈亚斯州及大多数健康地区因基层医疗敏感疾病导致的住院趋势呈下降趋势。在病因组中,男女趋势有所不同。我们观察到该州以及大多数健康地区的家庭健康战略覆盖范围与因基层医疗敏感疾病导致的住院趋势之间存在负相关。

结论

在分析期内,因基层医疗敏感疾病导致的住院病例有显著下降趋势。尽管呈逐步下降,但该比率仍然很高,且并非所有病因的下降趋势都是线性的。这些结果有助于指导公共政策,同时勾勒出该州按性别和地区划分的因基层医疗敏感疾病导致的住院情况概况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6be/6394382/c0648a814961/1518-8787-rsp-53-02-gf01.jpg

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