Trends in primary health care-sensitive conditions in Brazil

The role of the family health program (Project ICSAP-Brazil)

Ines Dourado, Veneza B. Oliveira, Rosana Aquino, Palmira Bonolo, Maria Fernanda Lima-Costa, Maria Guadalupe Medina, Eduardo Mota, Maria A. Turci, James MacInko

Research output: Contribution to journalArticle

Abstract

Background: This study describes trends in hospital admission rates for primary healthcare-sensitive conditions (PHCSC) in Brazil. Objectives: To evaluate the impact of increased primary healthcare availability through the implementation of the Family Health Program (FHP) on PHCSC admissions rates at the national, regional, and state-levels between 1999 and 2007. Research Design: An ecologic panel data study was used and a fixed effects multivariate negative binomial model was used to estimate the association of PHCSC admission rate and FHP controlling for other relevant covariates. Results: It was shown that, at the national level, PHCSC hospital admissions declined by 24%-over 2.5 times more rapidly than the decline in hospitalizations for all other (non-PHCSC) conditions. Greater reductions in the PHCSC admission rates when compared with the non-PHCSC admission rates were also observed when the data were divided by regions and states. Regression models showed that at the state level the greater the FHP coverage, the less was the PHCSC hospital admissions even when controlling for confounding variables. Conclusions: The results of this study have important implications for the healthcare model in countries that base their national health systems on primary healthcare. This is the first study to evaluate the association between FHP coverage and PHCSC admissions rates in all the Brazilian states over a long and relevant period for the consolidation of FHP in the country.

Original languageEnglish (US)
Pages (from-to)577-584
Number of pages8
JournalMedical Care
Volume49
Issue number6
DOIs
StatePublished - Jun 2011

Fingerprint

Family Health
Brazil
Primary Health Care
Delivery of Health Care
Confounding Factors (Epidemiology)
Statistical Models
Hospitalization
Research Design
Health

Keywords

  • ambulatory caresensitive conditions
  • evaluation of healthcare services
  • family health
  • primary healthcare

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Dourado, I., Oliveira, V. B., Aquino, R., Bonolo, P., Lima-Costa, M. F., Medina, M. G., ... MacInko, J. (2011). Trends in primary health care-sensitive conditions in Brazil: The role of the family health program (Project ICSAP-Brazil). Medical Care, 49(6), 577-584. https://doi.org/10.1097/MLR.0b013e31820fc39f

Trends in primary health care-sensitive conditions in Brazil : The role of the family health program (Project ICSAP-Brazil). / Dourado, Ines; Oliveira, Veneza B.; Aquino, Rosana; Bonolo, Palmira; Lima-Costa, Maria Fernanda; Medina, Maria Guadalupe; Mota, Eduardo; Turci, Maria A.; MacInko, James.

In: Medical Care, Vol. 49, No. 6, 06.2011, p. 577-584.

Research output: Contribution to journalArticle

Dourado, I, Oliveira, VB, Aquino, R, Bonolo, P, Lima-Costa, MF, Medina, MG, Mota, E, Turci, MA & MacInko, J 2011, 'Trends in primary health care-sensitive conditions in Brazil: The role of the family health program (Project ICSAP-Brazil)', Medical Care, vol. 49, no. 6, pp. 577-584. https://doi.org/10.1097/MLR.0b013e31820fc39f
Dourado, Ines ; Oliveira, Veneza B. ; Aquino, Rosana ; Bonolo, Palmira ; Lima-Costa, Maria Fernanda ; Medina, Maria Guadalupe ; Mota, Eduardo ; Turci, Maria A. ; MacInko, James. / Trends in primary health care-sensitive conditions in Brazil : The role of the family health program (Project ICSAP-Brazil). In: Medical Care. 2011 ; Vol. 49, No. 6. pp. 577-584.
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