Postgraduate Program in Psychology, Federal University of Pará, Belém, Pará, Brazil.
João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil.
PLoS One. 2021 Apr 8;16(4):e0248823. doi: 10.1371/journal.pone.0248823. eCollection 2021.
The Family Health Strategy (FHS) became consolidated as a primary care model and gatekeeper for the Unified Health System (Sistema Único de Saúde, SUS) in the Brazil and it is considered one of the largest primary health care programmes in the world. Its rapid expansion allowed the SUS to meet the changing health care needs of the population remote localities of Brazilian municipalities.
In the present study, exploratory data analysis was performed using modelling to provide a general overview of the study and to delineate possible structural characteristics of the cross-sectional time-series data. Panel regression methods were used to assess the association between FHS coverage and ambulatory care-sensitive hospitalizations (ACSH rates) in the municipalities of Pará, in the Brazilian Amazon, from 2008 to 2017.
The results showed strong evidence for the association between FHS coverage and ACSH rates, including reductions of 22% in preventable hospitalizations and 15% in hospital expenses that were directly linked to the 40% increase in FHS population coverage during the evaluated period. This expansion of primary care has mainly benefitted areas that are difficult to access and populations that were previously deprived of health care in the vast Amazon territory.
The findings of this study show that the increase of the expansion of primary care reduces the preventable hospitalization and the hospital expenses. This reinforces the need for public protection of the health of populations at risk and the positive impacts of primary care in the Brazilian Amazon.
家庭健康战略(FHS)已成为巴西初级保健模式和统一卫生系统(Sistema Único de Saúde,SUS)的守门人,被认为是世界上最大的初级保健计划之一。它的快速扩张使 SUS 能够满足巴西市政当局偏远地区人口不断变化的医疗需求。
本研究采用建模进行探索性数据分析,以提供研究的总体概述,并描绘横断面时间序列数据的可能结构特征。使用面板回归方法评估了 2008 年至 2017 年在巴西北部亚马孙地区帕拉州的 FHS 覆盖率与门诊医疗敏感住院率(ACSH 率)之间的关联。
结果表明,FHS 覆盖率与 ACSH 率之间存在很强的关联证据,包括可预防住院率降低 22%,住院费用降低 15%,这与评估期间 FHS 人口覆盖率增加 40%直接相关。在亚马孙广阔领土上,初级保健的这种扩张主要使难以获得医疗服务的地区和以前缺乏医疗服务的人群受益。
本研究的结果表明,初级保健扩张的增加降低了可预防的住院率和住院费用。这加强了对弱势群体进行公共保护的必要性,以及初级保健在巴西亚马孙地区的积极影响。