Structure and work process in primary care and hospitalizations for sensitive conditions

Authors

  • Waleska Regina Machado Araujo Universidade Federal do Maranhão
  • Rejane Christine de Sousa Queiroz Universidade Federal do Maranhão; Departamento de Saúde Pública
  • Thiago Augusto Hernandes Rocha Universidade Federal de Minas Gerais; Centro de Pós-Graduação e Pesquisa em Administração
  • Núbia Cristina da Silva Universidade Federal de Minas Gerais; Centro de Pós-Graduação e Pesquisa em Administração
  • Elaine Thumé Universidade Federal de Pelotas; Faculdade de Medicina; Departamento de Medicina Social
  • Elaine Tomasi Universidade Federal de Pelotas; Faculdade de Medicina; Departamento de Medicina Social
  • Luiz Augusto Facchini Universidade Federal de Pelotas; Faculdade de Medicina; Departamento de Medicina Social
  • Erika Barbara Abreu Fonseca Thomaz Universidade Federal do Maranhão; Departamento de Saúde Pública

DOI:

https://doi.org/10.11606/s1518-8787.2017051007033

Keywords:

Primary Health Care, organization & administration, Patient Admission, Outcome and Process Assessment (Health Care), Program Evaluation, Ecological Studies

Abstract

OBJECTIVE The objective of this study is to investigate whether the characteristics of the structure of primary health units and the work process of primary care teams are associated with the number of hospitalizations for primary care sensitive conditions. METHODS In this ecological study, we have analyzed data of Brazilian municipalities related to sociodemographic characteristics, coverage of care programs, structure of primary health units, and work process of primary care teams. We have obtained the data from the first cycle of the Brazilian Program for Improving Access and Quality of the Primary Care, of the Department of Information Technology of the Brazilian Unified Health System, the Brazilian Institute of Geography and Statistics, and the United Nations Development Programme. The associations have been estimated using negative binomial regression coefficients (β) and respective 95% confidence intervals, with a hierarchical approach in three levels (alpha = 5%). RESULTS In the adjusted analysis for the outcome in 2013, in the distal level, the coverage of the Bolsa Família Program (β = -0.001) and private insurance (β = -0.01) had a negative association, and the human development index (β = 1.13), the proportion of older adults (β = 0.05) and children under the age of five (β = 0.05), and the coverage of the Community Health Agent Strategy (β = 0.002) showed positive association with hospitalizations for primary care sensitive conditions. In the intermediate level, minimum hours (β = -0.14) and availability of vaccines (β = -0.16) showed a negative association, and availability of medications showed a positive association (β = 0.16). In the proximal level, only the variable of matrix support (β = 0.10) showed a positive association. The variables in the adjusted analysis of the number of hospitalizations for primary care sensitive conditions in 2014 presented the same association as in 2013. CONCLUSIONS The characteristics of the structure of primary health units and the work process of the primary care teams impact the number of hospitalizations for primary care sensitive conditions in Brazilian municipalities.

Published

2017-01-01

Issue

Section

Original Articles

How to Cite

Araujo, W. R. M., Queiroz, R. C. de S., Rocha, T. A. H., Silva, N. C. da, Thumé, E., Tomasi, E., Facchini, L. A., & Thomaz, E. B. A. F. (2017). Structure and work process in primary care and hospitalizations for sensitive conditions. Revista De Saúde Pública, 51, 75. https://doi.org/10.11606/s1518-8787.2017051007033