Reform movements in the Federal District Health Care System:conversion of the Primary Health Care assistance model

Elderly Mortality due to Ambulatory Care Sensitive Conditions and Primary Health Care Coverage in the Federal District

OBJECTIVES

To describe the mortality coefficients of elderly due to primary care sensitive conditions, from 2008 to 2018, and determine its association with the coverage of the Primary Health Care (Family Health Strategy and Basic Care models) in the Federal District.

METHODS

Ecological time series of mortality in Federal District elderly, from 2008 to 2018. The Poisson regression model was applied, considering as significant those with p<0.05, with a CI of 95%.

RESULTS

There were 70,503 deaths. There was a decrease in the risk of death of elders due to cardiovascular diseases and diabetes. Higher primary care coverage decreased the chance of death by sensitive conditions, both in Basic Care (OR: 0.994, CI: 0.990-0.998) and in the Family Health Strategy (OR: 0.997, CI: 0.995-0.999).

CONCLUSIONS

Primary Care coverage was associated with a lower chance of death of the elderly due to Ambulatory Care Sensitive Conditions, especially in Basic Care.

TREND OF THE HOSPITALIZATIONS DUE TO AMBULATORY CARE SENSITIVE CONDITIONS IN PEDIATRICS IN DISTRITO FEDERAL

ABSTRACT Objective: to analyze the trend of hospitalizations due to Ambulatory Care Sensitive Conditions in Pediatrics in Distrito Federal, during the 2008-2018 period. Method: a time series study conducted between 2008 and 2018 with data from Distrito Federal, Brazil, in the age group from 0 to 14 years old. The data were collected in the SUS Hospital Information System, and they were used to perform trend analyses of the most frequent groups. Results: there was a trend towards a significant increase in hospitalizations in the age group studied, with an annual percentage variation of 1.42% and a confidence interval between 0.05 and 2.81. Four groups of reasons for hospitalization and diagnoses were more frequent in the period, namely: bacterial pneumonias, infectious gastroenteritis and complications, pulmonary diseases, and asthma. Among the most frequent groups, considering the study period, there was a trend towards a significant increase in pulmonary diseases (15.71%; 12.40 and 19.12); a trend towards a significant reduction in infectious gastroenteritis and complications (-5.35%; -8.01 and 2.61); and a stationary trend in bacterial pneumonias (-0.43%; -3.80 and 3.07) and asthma (3.82%; 0.57 and 8.40). Conclusion: the results of this study can contribute to the planning, evaluation and monitoring of primary care actions, as this indicator aims at indirectly evaluating access and effectiveness of this care level. In this sense, considering the results of the trend analysis performed, it can be concluded that they do not yet reflect the expected results with the expansion of FHS coverage.