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[初级卫生保健战略及其对2000 - 2017年巴拉圭非住院治疗敏感疾病可避免住院情况的影响：初级卫生保健战略及其对巴拉圭2000 - 2017年门诊护理敏感疾病可避免住院的影响]

[Primary health care strategy and its impact on avoidable hospitalizations for ambulatory care-sensitive conditions, Paraguay, 2000-2017Estratégia de atenção primária à saúde e seu impacto nas internações hospitalares evitáveis por causas sensíveis à atenção ambulatorial, Paraguai, 2000-2017].

作者信息

Lerea María José, Tullo Juan Edgar, López Pedro

机构信息

Dirección de Análisis de la Información en Salud/Dirección General de Información Estratégica en Salud Dirección de Análisis de la Información en Salud/Dirección General de Información Estratégica en Salud Ministerio de Salud Pública y Bienestar Social Paraguay Dirección de Análisis de la Información en Salud/Dirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar Social, Paraguay.

Organización Panamericana de la Salud Organización Panamericana de la Salud Paraguay Organización Panamericana de la Salud, Paraguay.

出版信息

Rev Panam Salud Publica. 2019 Aug 22;43:e69. doi: 10.26633/RPSP.2019.69. eCollection 2019.

DOI:10.26633/RPSP.2019.69
PMID:31456822
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6705332/
Abstract

OBJECTIVE

Explore the effect of the implementation and strengthening of the primary care strategy (PHC) on hospitalizations for ambulatory care-sensitive conditions (HACSC).

METHODS

Descriptive cross-sectional observational study that considered the data from public hospital admissions records for the entire country for the period 2000-2017. The starting point of the PHC strategy is considered to be 2009. The diagnoses proposed by the Pan American Health Organization/World Health Organization were used in defining the HACSC diagnoses. The analysis of HACSC behavior considered two stages: 2000-2008 and 2009-2017.

RESULTS

HACSC trended downward, with a difference of 6.75% between the final years of each stage. The greater the PHC coverage, the larger the reduction. The leading causes of HACSC were pneumonia and acute diarrheal disease. Admissions for chronic diseases largely fell, while admissions for infectious diseases rose.

CONCLUSIONS

The degree of population coverage and access to family health units can limit the impact of PHC on HACSC. A reduction in HACSC was confirmed after PHC implementation in Paraguay. The results for admissions for chronic diseases are better than those for infectious diseases.

摘要

目的

探讨实施并强化初级保健策略（PHC）对门诊可预防住院（HACSC）的影响。

方法

描述性横断面观察性研究，纳入了2000 - 2017年全国公立医院入院记录数据。PHC策略的起始时间设定为2009年。采用泛美卫生组织/世界卫生组织提出的诊断标准来定义HACSC诊断。对HACSC行为的分析分为两个阶段：2000 - 2008年和2009 - 2017年。

结果

HACSC呈下降趋势，每个阶段最后一年之间的差异为6.75%。PHC覆盖范围越大，降幅越大。HACSC的主要病因是肺炎和急性腹泻病。慢性病入院人数大幅下降，而传染病入院人数上升。

结论

人口覆盖程度和获得家庭健康单位服务的机会会限制PHC对HACSC的影响。巴拉圭实施PHC后，HACSC有所减少得到证实。慢性病入院情况的结果优于传染病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/c07e330d1498/rpsp-43-e69_Figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/187a758233ec/rpsp-43-e69_Figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/7bc7df893670/rpsp-43-e69_Figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/a6173c3e2cf8/rpsp-43-e69_Figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/c07e330d1498/rpsp-43-e69_Figure4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/187a758233ec/rpsp-43-e69_Figure1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/7bc7df893670/rpsp-43-e69_Figure2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/a6173c3e2cf8/rpsp-43-e69_Figure3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2845/6705332/c07e330d1498/rpsp-43-e69_Figure4.jpg

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