Characteristics of primary care and rates of pediatric hospitalizations in Brazil.
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2020-01
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Abstract
Objective
To evaluate the association among characteristics of primary health care center (PHCC) with hospitalizations for primary care sensitive conditions (PCSC) in Brazil.Method
In this study, a cross-sectional ecological study was performed. This study analyzed the 27 capitals of Brazil's federative units. Data were aggregated from the following open access databases: National Program for Access and Quality Improvement in Primary Care, the Hospital Information System of Brazilian Unified Health System and Annual Population Census conducted by the Brazilian Institute of Geography and Statistics. Associations were estimated among characteristics of primary care with the number of three PCSC as the leading causes of hospitalization in children under-5 population in Brazil: asthma, diarrhea, and pneumonia.Results
In general, PHCC showed limited structural adequacy (37.3%) for pediatric care in Brazil. The capitals in South and Southeast regions had the best structure whereas the North and Northeast had the worst. Fewer PCSC hospitalizations were significantly associated with PHCC which presented appropriate equipment (RR: 0.98; 95%CI: 0.97-0.99), structural conditions (RR: 0.98; 95%CI: 0.97-0.99), and signage/identification of professionals and facilities (RR: 0.98; 95%CI: 0.97-0.99). Higher PCSC hospitalizations were significantly associated with PHCC with more physicians (RR: 1.23, 95%CI: 1.02-1.48), it forms (RR: 1.01, 95%CI: 1.01-1.02), and more medications (RR: 1.02, 95%CI: 1.01-1.03).Conclusion
Infrastructural adequacy of PHCC was associated with less PCSC hospitalizations, while availability medical professional and medications were associated with higher PCSC hospitalizations.Type
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Lisboa, Lívia Anniele Sousa, Rejane Christine de Sousa Queiroz, Erika Bárbara Abreu Fonseca Thomaz, Núbia Cristina da Silva, Thiago Augusto Hernandes Rocha, João Ricardo Nickenig Vissoci, Catherine Ann Staton, Adriana Lein, et al. (2020). Characteristics of primary care and rates of pediatric hospitalizations in Brazil. Revista de saude publica, 54. p. 32. 10.11606/s1518-8787.2020054001784 Retrieved from https://hdl.handle.net/10161/22017.
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Catherine Ann Staton
Catherine Staton MD MSc
Dr. Staton is a Professor in Emergency Medicine (EM), Neurosurgery, Population Health & Global Health with tenure at Duke University. She is the Director of the GEMINI (Global EM Innovation & Implementation) Research Center and the EM Vice Chair of Research Strategy & Faculty Development. Her research integrates innovative implementation methods into health systems globally and locally to improve access to acute care. In 2012, with an injury registry at Kilimanjaro Christian Medical Center, Tanzania Dr. Staton demonstrated 30% of injury patients had at risk alcohol use, providing preliminary data for a K01/Career Development Award. Her K01 award adapted a brief alcohol intervention to the KCMC ED and Swahili. This intervention has been proven to reduce 24 binge drinking events per year compared to usual care, and the team is now funded to plan for regional implementation. Dr. Staton and her mentor and collaborator Dr. Mmbaga are co-PD of the “The TReCK Program: Trauma Research Capacity Building in Kilimanjaro” to train 12 masters and doctoral learners to conduct innovative implementation and data science projects to improve care for injury patients. The success of this program has been impressive with learners writing, submitting and being awarded and R21 to improve care for older adult trauma patients at KCMC. Dr. Staton also is working stateside as an implementation scientist on both health system and quality care at Duke as well as implementation science for climate change work in the Carolinas. Dr. Staton and GEMINI partners with over two dozen faculty from low- and middle-income countries to conduct research, has mentored over 150 learners from undergraduate to post-doctoral levels from high, middle and low- income settings and has over 200 manuscripts.
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