Public Health Department, Faculty of Health Sciences, University of Brasilia, Brasilia, Federal District, Brazil.
PLoS One. 2022 Aug 5;17(8):e0272650. doi: 10.1371/journal.pone.0272650. eCollection 2022.
In Brazil, the Unified Health System (Sistema Único de Saúde, or SUS) provides health care, and an aging population overwhelms the system due to the greater vulnerability of the elderly. In the Federal District, two models of primary care coexist-the traditional primary care and the family health strategy. The present study aimed to analyze the factors associated with mortality of the elderly due to conditions sensitive to ambulatory care in the Federal District, Brazil.
This cross-sectional study investigated all deaths that occurred in people over 60 years old between 2008 and 2018. The variables studied were age at death, sex, marital status, education, race/color, death by condition sensitive to ambulatory care, and population coverage of primary care services. The Urban Well-Being Index (UWBI) was used, which includes the dimensions: mobility, environmental and housing conditions, infrastructure, and collective services, to analyze issues related to the place where the senior citizen resides.
The deaths 70,503 senior citizens were recorded during the study period. The factors associated with mortality in the elderly due to ambulatory care sensitive conditions were male, lower income, and less education. Residing in a place with poor UWBI presented a response gradient with higher mortality. Increased ambulatory care coverage was also associated with lower mortality.
The study evidenced an association between male gender, age, income, and education, and UWBI with lower mortality due to ambulatory care sensitive conditions, and these associations presented a response gradient. The study also found that increased coverage of the elderly population was associated with lower mortality from sensitive conditions.
在巴西，全民健康覆盖系统（Sistema Único de Saúde，或 SUS）提供医疗保健服务，但由于老年人的脆弱性增加，人口老龄化使该系统不堪重负。在巴西联邦区，存在两种基层医疗模式——传统基层医疗和家庭医疗策略。本研究旨在分析与巴西联邦区老年人因可在门诊治疗的疾病而导致的死亡率相关的因素。
本横断面研究调查了 2008 年至 2018 年期间 60 岁以上人群的所有死亡病例。研究的变量包括死亡时的年龄、性别、婚姻状况、教育程度、种族/肤色、因可在门诊治疗的疾病导致的死亡以及基层医疗服务的人口覆盖率。使用城市福祉指数（Urban Well-Being Index，UWBI），其中包括流动性、环境和住房条件、基础设施和集体服务等维度，分析与老年人居住地点有关的问题。
在研究期间记录了 70503 名老年人的死亡。与因可在门诊治疗的疾病导致的老年人死亡率相关的因素包括男性、较低的收入和较低的教育程度。居住在 UWBI 较差的地方与更高的死亡率呈响应梯度关系。增加门诊护理的覆盖率也与较低的死亡率相关。
本研究表明，男性性别、年龄、收入和教育程度与 UWBI 与因可在门诊治疗的疾病导致的死亡率较低之间存在关联，且这些关联呈响应梯度关系。研究还发现，老年人的覆盖率增加与因敏感条件导致的死亡率降低有关。
