Rodrigues Mayara Marta, Alvarez Angela Maria, Rauch Keila Cristina
Universidade Federal de Santa Catarina - Florianópolis (SC), Brasil.
Universidade do Sul de Santa Catarina - Florianópolis (SC), Brasil.
Rev Bras Epidemiol. 2019 Mar 14;22:e190010. doi: 10.1590/1980-549720190010.
To analyze the trends in hospitalization and mortality rates for ambulatory care sensitive conditions (ACSC) among older adults in the state of Santa Catarina, Brazil, from 2008 to 2015.
Ecological time-series study based on data from the Hospital Information System (Sistema de Informações Hospitalares - SIH) of the public health system (Sistema Único de Saúde - SUS), using hospital admission authorization forms as data source, from 2008 to 2015, in Santa Catarina. Data were analyzed by gender and age, which was stratified into two age groups: 60 to 79 years and 80 years or older. We standardized age rates using the direct method and statistical analysis using segmented linear regression (joinpoint regression).
Sensitive conditions led to 41% of total hospitalizations of older adults in 2008 and 32% in 2015. The annual rate variation decreased [-4.6^ 95%CI (-5.7; -3.6)]. The most prevalent causes were: heart failure, chronic obstructive pulmonary disease, and cerebrovascular diseases. Hospitalization mortality rates dropped, regardless of gender and in the age group up to 80 years, representing an annual variation of -2.4%, with -2.1% for males and -2.7% for females.
Analyzing the ACSC indicator, which evaluates the quality and effectiveness of primary care, the results of this research revealed a reduction in hospitalization rates among older adults, regardless of gender and age groups established in this study.
分析2008年至2015年巴西圣卡塔琳娜州老年人门诊医疗敏感疾病（ACSC）的住院率和死亡率趋势。
基于公共卫生系统（单一卫生系统 - SUS）的医院信息系统（医院信息系统 - SIH）的数据进行生态时间序列研究，使用医院入院授权表作为数据源，时间跨度为2008年至2015年，研究地点为圣卡塔琳娜州。数据按性别和年龄进行分析，年龄分为两个年龄组：60至79岁和80岁及以上。我们使用直接法对年龄率进行标准化，并使用分段线性回归（连接点回归）进行统计分析。
2008年，敏感疾病导致老年人住院总数的41%，2015年为32%。年发病率变化下降[-4.6^ 95%CI（-5.7；-3.6）]。最常见的病因是：心力衰竭、慢性阻塞性肺疾病和脑血管疾病。住院死亡率下降，无论性别如何，在80岁及以下年龄组中也是如此，年变化率为-2.4%，男性为-2.1%，女性为-2.7%。
通过分析评估初级保健质量和有效性的ACSC指标，本研究结果显示，无论性别和本研究设定的年龄组如何，老年人的住院率均有所下降。
