Internações por condições sensíveis à atenção primária em Minas Gerais: análise da prevalência e dos gastos nas macrorregiões de saúde

Abstract

Hospitalizations due to Ambulatory Care Sensitive Conditions are an indicator of the effectiveness of Primary Health Care through hospital activity and represent problems of access and quality that impact the spending of the Unified Health System. PHC has been consolidated in the country through the expansion of coverage by the Family Health Strategy, which has a differentiated look at health demands under the broader conception of health and has been able to improve indicators such as vaccine coverage, reduction of infant mortality and ACSC. OBJECTIVE: to analyze the prevalence and expenditure with ACSC in the state and macro-regions of health of Minas Gerais. METHODOLOGY: an ecological study, carried out for the years 2009 and 2014. The Authorizations for Hospital Stay of the Hospital Information System-UHS were extracted and separated in hospitalizations for general causes and by ACSC, selected according to the Brazilian list of 2008. The database included the hospitalizations and the structure variables of services for the health macro-regions of MG and for the state. It was decided to study the age groups of children (0 to 12 years) and the elderly (60 years and over). Descriptive analysis of the prevalence and expenditures with ACSC was made and the identification of possible statistical associations between the structural variables and the ACSC, both in the state and in the macro-regions of health, occurred through the Pearson correlation, assuming as a statistically significant association value of p≤0.05. RESULTS: a first study analyzed the scenario of ACSC in the state of Minas Gerais and there was a tendency to reduce expenditures and ACSC rates between the years. The most prevalent causes of ACSC were Heart Failure for the elderly and Gastroenteritis and Bacterial Pneumonias for children. The coverage by the FHS showed a statistically significant association with the ACSC. For macroregional analysis, there was a tendency to reduce rates and spending in most macro-regions of health, with a great variability of regional scenarios, evidencing the diversity of the state. Few statistical association was established between the structural variables and the ACSC, in most of the macro regions. CONCLUSION: the trend towards the reduction of ACSC and expenditures with hospitalizations considered avoidable was observed in the state and in most macro-regions of the state, but worse results were observed in macro-regions of lower socioeconomic development. The expansion of coverage by the FHS, besides helping to consolidate and strengthen the PHC, is associated with the reduction of the ACSC in the state of MG. It is necessary to know the health expenditures to assist the management in the planning and rational use of financial resources in health.